| Tue, Jul 14, 2020 @ 09:00 AM

Dual Special Needs Plan: For People with Medicare & Medicaid

Posted by Medicare Made Clear

Some people are eligible to have both Medicare and Medicaid. These people are considered “dual eligible,” and they also qualify to enroll in a special kind of Medicare Advantage plan known as a Dual Special Needs Plan (DSNP).

Watch the video below to learn about dual special needs plans, who can get one, what they cover and what makes them special.

What Is A Dual Special Needs Plan?

A dual special needs plan is a special kind of Medicare Advantage coordinated-care plan. It is an all-in-one plan that combines your Medicare Part A and Part B benefits, your Medicare Part D prescription drug coverage, your Medicaid benefits and additional health benefits such as vision, dental or fitness.

Who Can Get A Dual Special Needs Plan?

You can get a dual special needs plan if you meet the following qualifications:

  1. You are eligible Medicare and Medicaid and have both.
  2. You have Medicare Part A and Part B.
  3. You live in the plan’s area.

What Does A Dual Special Needs Plan Cover?

Just like any other Medicare Advantage plan, a dual special needs plan will include coverage for Medicare Part A and Part B. It will also include Part D prescription drug coverage and extra benefits not provided by either Medicare or Medicaid.

Examples of extra benefits a dual special needs plan may provide include:

  • Credits to buy health products
  • Transportation assistance
  • Care coordination via a personal care coordinator
  • Personal emergency response system (PERS)
  • Tele-health options such as virtual medical visits with your doctor
  • Worldwide emergency coverage

The extra benefits offered will vary by plan, provider and location.

A Special Note About Enrolling In DSNP Plans

If you qualify for Medicaid and are enrolled in Medicare, you may be able to enroll in a dual special needs plan during the first nine months of the year in a Special Enrollment Period, rather than the Medicare Annual Enrollment Period (AEP) in the fall

Learn more about being dual-eligible and about dual-eligible coverage options here.