Growing Number of People Join Medicare Advantage Dual Eligible Special Needs Plans

Medicare Bob
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Are you dually eligible for Medicare and Medicaid programs? Get answers about Dual Elgible Special Needs Plans.
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In May 2021, 11.5 million more people were enrolled in Medicaid than the previous enrollment in February 2020. Economic uncertainty throughout the COVID-19 pandemic has led to a steady increase in Medicaid participants during a time where job and income loss have become more and more prevalent.

As Medicaid enrollment increases month after month, more people are becoming dually eligible for Medicare and Medicaid programs and can join a Dual Eligible Special Needs Plan (D-SNP).

What are Dual Eligible Special Needs Plans?

D-SNPs are a kind of Medicare Advantage plan that offer extra benefits at no additional cost. They combine benefits from Medicare part A and B, Medicare Part D prescription coverage, Medicaid benefits and other benefits — like vision and dental — that would otherwise be paid out-of-pocket. 

Additional benefits of a D-SNP vary by plan, provider and location and might include things like transportation assistance, credits to buy health-related products, a personal care coordinator, telehealth options, personal emergency response systems and more. 

Basic requirements for a D-SNP include: 

  • Having both Medicare and Medicaid

  • Having Medicare parts A and B

  • Living within a plan’s area

As of February 2021, D-SNPs are in operation in 43 states and Washington, D.C. In 2022, 295 D-SNPs will be available, compared to 256 in 2021.

There are a few other key points to remember when it comes to D-SNPs.

Other Important D-SNP Frequently Asked Questions

First, when will you enroll in a D-SNP?

Those qualifying for a D-SNP can enroll for no monthly premium during the first nine months of the year in a Special Enrollment Period instead of waiting for the Medicare Annual Enrollment Period in the fall.

What if you need some additional support via Medicare Part D Extra Help?

To qualify for this program, which assists in paying Medicare prescription drug costs, you must:

  • Be receiving Medicare

  • Have limited resources and income

  • Live in one of the 50 United States or the District of Columbia

You could also automatically qualify for Part D Extra Help if you have one of the following:

  • Supplemental Security Income (SSI) and Medicare

  • Medicaid and Medicare

  • The Medicare Savings Program

Who Pays First: Medicaid or Medicare?

When a provider charges for a service, Medicare pays first, and Medicaid pays second. Medicaid also pays after employer group health plans and Medicare Supplement (Medigap) Insurance have paid. Medicaid will never pay first for anything covered by Medicare.

Call Senior Healthcare Direct at 1-833-463-3262, TTY 711 to speak with a licensed agent about enrolling in a Medicare Advantage Dual Eligible Special Needs Plan.

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LEGAL DISCLAIMER: The above is meant to be strictly educational and not intended to provide medical advice or solicit the sales of an insurance product or service of any kind.

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