If you happen to qualify for each Medicare and Medicaid, meaning you’re “dual eligible” and will be eligible to enroll in a dual qualifying special needs plan (D-SNP). D-SNP is a kind of Medicare Advantage plan that is offered by private insurance firms. D-SNPs have an agreement together with your state Medicaid program to assist coordinate your Medicare and Medicaid advantages.
Let’s take a have a look at the fundamentals of D-SNP, including common benefits and discover for those who qualify.
Benefits and advantages of D-SNP
D-SNPs differ from other varieties of Medicare Advantage plans because they serve beneficiaries who’re dual-eligible for Medicare and Medicaid. Key advantages for enrollees include low price of insurance, easy accessibility to support or simpler care coordination, and extra plan advantages. Here’s what you’ll want to know.
Low price of insurance
Dually eligible enrollees have options to get help with premiums, deductibles, copayments and co-insurance. Chances are you’ll still need to pay the monthly Medicare Part B premium, and you might have a separate D-SNP plan premium – however it’s normally cheaper. While the premium varies by plan, many D-SNPs offer subsidized premiums, which implies your monthly payment may haven’t any cost or could also be low.
Coordination of comfort and care
If you’re enrolled in two varieties of coverage, resembling Original Medicare and Medicaid, things can get a bit complicated – how do you understand which kind of coverage pays for what, and coordinate care? Sometimes, Medicaid enrollees who’re 65 or older do not know they qualify for Medicare.
Those registered with the D-SNP have access to a Care Coordinator, which is a requirement for all Special Needs Plans. A care coordinator can make it easier to manage your care by developing a plan with you, coordinating your services and answering your questions.
Additional advantages and support
Dual qualifying special needs plans may offer additional advantages that Medicare or Medicaid coverage alone doesn’t provide. Exact advantages vary by plan, but may include assistance or coverage for:
- Medical
- Dental
- Long-term care
- Home and community services
- Hearing and visual services
- Telehealth services
- Preventive measures
- transportation needs
- Medical equipment
Who is eligible for D-SNP?
A Dual Eligible Special Needs Plan will be a great option for individuals who need extra support, resembling those from low-income households or those with chronic medical conditions or disabilities. If you happen to are excited about enrolling in D-SNP, you need to be eligible for each Medicare and Medicaid.
To qualify for Medicare, you need to be:
- U.S. citizen or person legally residing within the U.S
- 65 years or older
- Under 65 with special disabilities
- Former payer of social security contributions for at the very least 10 years
Medicaid eligibility will be a bit more complex. Each state has its own rules for judging who is eligible and who is not. Normally, this will be influenced by a combination of things resembling income, age, housing situation, household size or disability.
Is the Dual Eligible Special Needs Plan best for you?
There are various the explanation why a Medicare-Medicaid enrollee might use a D-SNP plan. Medicaid itself is a great program, but sometimes its coverage is probably not enough. A dual-qualifying plan can offer Medicare coverage together with Medicaid and sometimes with additional advantages at a reasonable price – so you possibly can get the care you wish.
Have more questions on the Dual Eligible Plan for Individuals with Special Needs?
Our experts are here to make it easier to find the perfect Medicare plan on your lifestyle. HealthPartners offers a dual-eligible special needs plan for those enrolled in Medicare and Medicaid called Minnesota Senior Health Options (MSHO).