DSNP
D-SNPs are Dual Eligible Special Needs Plans (D-SNPs). These plans are for individuals who are eligible for both Medicare and Medicaid.
DSNP
What Are D-SNPs?
D-SNPs are a special type of Medicare Advantage plans that provide healthcare coverage for dual eligible people (people who qualify for both Medicare and Medicaid). D-SNP benefits vary state by state, but generally these plans may include:
- $0 monthly premiums
- Care coordination
- Vision and hearing benefits
- Prescription drug coverage
- Over the counter quarterly benefits
- Transportation benefits
- Gym memberships
- Telehealth services
These plans offer a bundled Original Medicare and Medicare Part D (prescription drug coverage). There are 5 different types of D-SNP plans, each offering varying degrees of Medicaid coverage:
- All Dual
- Full Benefit
- Medicare Zero Cost Sharing
- Dual Eligible Subset
- Dual Eligible Subset Medicare Zero Cost Sharing
Beneficiaries must meet eligibility requirements for both programs and be enrolled in both.
Who is Eligible for D-SNPs?
Approximately 12 million Americans, or 20% of the Medicare population, are eligible for D-SNPs. To be eligible, you must qualify for both Medicare and Medicaid.
You are eligible for Medicare if you are 65 or older or have a qualifying disability. You are eligible for Medicaid if your income level falls below your state’s threshold (generally you need to make less than 100-200% of the federal poverty level).
How Do D-SNPs Work?
With D-SNPs, Medicare is always the first (primary) payer. After Medicare pays its share, Medicaid (the secondary payer) covers the remaining cost for Medicaid covered expenses. Medicaid can help cover the costs of Medicare premiums, copayments, and deductibles as well.
Medicaid covers some expenses Original Medicare doesn’t cover, such as personal care assistance in your home, so getting both Medicare and Medicaid if you are dually eligible can save you money.
Get Enrolled In the Right Plan For You
Senior Health Solutions can help you make the right choice for you and your healthcare needs. Located in Opelika, AL, we have years of experience helping people make health care decisions that give them peace of mind. Give us a call today at (866) 445-5215.
