Dual Special Needs Plans
Dual-Eligible Special Needs Plan (D-SNP) is a Special Needs Plan under the Medicare Advantage Plan that limits the enrollment of eligible Medicare Beneficiaries who meet specific eligibility criteria. It covers individuals who qualify for both Medicare and Medicaid coverage. Medicare provides health benefits for people over the age of 65. Persons younger than 65 may also qualify for other reasons, including a disability or a chronic condition. Medicaid is, however, targeted at people with low income and provides health benefits for them.
A D-SNP will offer coverage for Original Medicare (Medicare Part A and Medicare Part B) and prescription drugs (Medicare Part D). A Dual-Eligible Special Needs Plan is commonly confused with a Medicare Advantage Medicare-Medicaid Plan (MMP). While MMPs only serve full benefit dual (Medicare/Medicaid) eligible beneficiaries and some additional limitations may apply (such as state-specific requirements), a D-SNP does not.
D-SNPs include all Medicaid eligibility categories, including full Medicaid, Specified Low-income Medicare beneficiary, Qualifying Individual, and Qualified Medicare Beneficiary. With D-SNPs, you get more benefits that are not usually covered with Original Medicare. D-SNPs are a combination of doctor, hospital and prescription coverage, and over-the-counter (OTC) products, all in one plan. The eligibility category may vary depending on the state.
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