Collin County Dual-Eligible Medicare Plans

What is a Dual Special Needs Plan (D-SNP)?

Dual Special Needs Plans are for people who have both Medicare and Medicaid (called “dual eligible”). A Dual Special Needs Plan (D-SNP) is a unique Medicare Advantage plan that combines your Medicare Part A and Part B benefits, and your Medicare Part D prescription drug coverage. You’ll get extra support to help coordinate the plan with your Medicaid plan. In addition, a dual health plan provides extra benefits not provided by either Medicare or Medicaid.

Dual Special Needs Plans are for people who could use some extra help. That may be because of income, disabilities, age, and/or health conditions. Dual Special Needs Plans are a type of Medicare Advantage plan. Dual Special Needs Plans are also called D-SNP for short. These names all mean the same thing.

A Dual Special Needs Plan works together with your Medicaid health plan. You’ll keep all your Medicaid benefits. Most dual health insurance plans also give you more benefits and features than you get with Original Medicare. All with as low as a $0 plan premium.

Although most people become eligible for Medicare when they turn 65, Medicare eligibility is also triggered for people under age 65 once a person has been receiving disability benefits for 24 months or has ALS or end-stage renal disease. Nationwide, 16 percent of all Medicare beneficiaries are eligible due to disability.

Special Needs Plans (SNPs), created by Congress in 2003, are a type of Medicare Advantage (MA) plan that limits membership to people with specific diseases or characteristics. Dual Eligible Special Needs Plans (D SNPs), one type of SNP, enroll only individuals dual-eligible for Medicare and Medicaid.

Who qualifies for a Dual Special Needs Plan?

 To qualify for a D-SNP, you must receive Original Medicare (Parts A and B) and full Medicaid benefits. Depending on the amount of Medicaid benefits you receive, you may be considered a “full dual-eligible” or a “partial dual-eligible.” If you receive full Medicaid benefits, you will be fully dual-eligible. Most of the time, individuals who qualify get a letter from their state Medicaid office. You can also call to find out your status.

What extra benefits may be included with a Dual Special Needs Plan?

Dental, vision, and hearing coverage, care coordination via a personal care coordinator, personal emergency response system (PERS), telehealth options such as virtual medical visits with your doctor, credits to buy health products, plus transportation assistance, and more. These are just a handful of examples of the extra benefits Dual Special Needs Plans typically include. Each plan is different, so be sure to look at what’s available where you live.

What happens to my Medicaid benefits?

A Dual Special Needs Plan doesn’t replace your Medicaid plan or change your Medicaid eligibility. You’ll keep the same Medicaid plan you have today, and you’ll still get all the same Medicaid benefits you get now.