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Medicare Duel Eligible Special Needs

By Dave Miller

What Does a Dual-Eligible Special Needs Plan (D-SNP) Cover? If you qualify for Medicare and Medicaid, a dual eligible special...
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What Does a Dual-Eligible Special Needs Plan (D-SNP) Cover?

If you qualify for Medicare and Medicaid, a dual eligible special needs plan may offer the extra support and savings you need.

What is a D-SNP?

A D-SNP is a type of Medicare Advantage plan created specifically for people who have both Medicare and Medicaid. These plans coordinate your care, provide enhanced support, and tailor benefits for those who often face greater health or financial challenges.

Because D-SNPs bring both programs together under one umbrella, they’re sometimes called dual advantage plans or dual special needs plans. The goal is to make managing your healthcare simpler and more affordable.

What D-SNPs Typically Cover

• Full Medicare benefits (Parts A & B): Hospital stays, doctor visits, preventive services, skilled nursing, lab work, and durable medical equipment — just like other Medicare Advantage plans.

• Prescription drug coverage (Part D): D-SNPs include built-in Part D, often with no or minimal copays depending on your Medicaid level. Many also offer a broader drug list than standard Part D plans.

• Medicaid benefits (state-based): May include long-term care, personal support, transportation to medical visits, and home or community services — based on your state’s Medicaid rules.

• Routine extras: Many plans add dental cleanings, vision exams, hearing aids, and over-the-counter (OTC) allowances for items such as vitamins or pain relievers.

Care Coordination Makes a Difference

Many D-SNPs include a dedicated care coordinator or case manager who can reduce hospital stays and eliminate confusion. They can help explain how to use your benefits, schedule doctor visits and follow-ups, manage chronic conditions, and connect your Medicare and Medicaid services so nothing gets missed.

Why D-SNPs Matter

Navigating two government programs can be overwhelming. A D-SNP brings them together under one card and one team, simplifying life. If you’re eligible, you could enjoy stronger coverage, lower costs, and more confidence in your care.

We’re Here to Help

Call 1-855-890-2583 to connect with an Education Specialist about available D-SNPs in your area and find the right plan for your needs.

 

 

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