What is a Dual-Eligible Special Needs Plan?
People who qualify for both Medicare and Medicaid are considered “dual-eligible.” If this is the case for you, you have a few different options for health care coverage. A Dual-Eligible Special Needs Plan (D-SNP) is one choice to consider. These plans are approved by Medicare but are run by private companies like Highmark. Below, learn more about what D-SNPs are and the unique benefits they offer.
What is a D-SNP and how does it work?
A D-SNP is your Medicare plan, and it also helps to coordinate your Medicaid benefits. When you enroll, you receive primary coverage for your hospital, medical, and prescription drug benefits through one plan. Your plan provider helps to coordinate care between your doctors, so you get the most comprehensive care available to you.
Who is eligible for a D-SNP?
As we mentioned above, you can join a D-SNP if you qualify for both Medicare and Medicaid. Beyond that, there are a few basic requirements. You must:
- Be a U.S. citizen or a lawful, permanent resident.
- Qualify for Original Medicare (Parts A and B).
- Meet the financial requirements for your state’s Medicaid program.
- Live in an area where D-SNPs are offered.
What does a D-SNP cover?
All medically necessary and preventive services offered under Parts A and B are covered, in addition to prescription drug coverage under Part D. Many D-SNPs also offer extra benefits that Original Medicare doesn’t, including:
- $0 to low monthly premiums.
- Dental, vision, and hearing allowances.
- Transportation to and from appointments.
- Over-the-counter allowances for products like aspirin, toothpaste, and antacids.
- Allowances for food and utilities.
- Personal Emergency Response Systems (PERS), also referred to as medical alert systems.
We can help you find the right D-SNP
Highmark Wholecare has D-SNPs in Pennsylvania for a variety of Medicaid assistance levels. Our plans give you access to a wide network of doctors and hospitals — and they’re packed with extra benefits to help you stay healthy and save money.
If you or someone you know is ready to start exploring plans, you can learn more about Highmark Wholecare options by visiting Highmark’ Wholecare’s Plan Finder. If you live outside of Pennsylvania, visit medicare.gov to find options in your area.
Health benefits or health benefit administration may be provided by or through Highmark Wholecare, coverage by Gateway Health Plan, an independent licensee of the Blue Cross Blue Shield Association (“Highmark Wholecare”).
Health benefits or health benefit administration may be provided by or through Highmark Wholecare, coverage by Gateway Health Plan, an independent licensee of the Blue Cross Blue Shield Association (“Highmark Wholecare”)."