D-SNP: Unique health plans for people with both Medicare and Medicaid

If you’re eligible for both Medicare and Medicaid, you should know about an option that offers more benefits than Original Medicare that may help manage your whole health with prescription coverage, preventive dental, mental health support and more.

Most of us have heard of Medicare and Medicaid. Medicare provides health benefits for people over age 65 as well as people younger than 65 who qualify due to a disability. Some people eligible for Medicare have opted to get their benefits through a Medicare Advantage plan, which is a plan offered by a private insurance company approved by the federal government.

Medicaid, in turn, provides health benefits for people with low income or a disability. Medicaid is administered by your state, and eligibility criteria can vary. A Dual Special Needs Plan – or D-SNP for short – is a special type of Medicare Advantage plan that provides health benefits for people who are “dually eligible,” meaning they qualify for both Medicare and Medicaid. These members may be eligible for a UnitedHealthcare Dual Complete plan, which is a D-SNP. This might be able to provide more help than a Medicare or Medicaid plan alone.

People who meet the eligibility criteria for both Medicare and Medicaid are qualified to enroll in a D-SNP. They often face unique health needs and could use assistance supporting their health and quality of life.

For instance, they may:

• Have a disabling condition and struggle with daily activities such as bathing and dressing
• Suffer from a cognitive impairment or a mental disorder
• Receive care from multiple doctors to manage a variety of health conditions
• Be more likely to need in-home care providers or other health and social services
   

More than 2.6 million people are enrolled in D-SNPs in 2020, which represents 9.5% of all people enrolled in Medicare.

Medicare and Medicaid are important sources of health care benefits for millions of Americans, but the programs can be confusing and tough to navigate. This is especially true for people eligible for both programs. By coordinating Medicare and Medicaid benefits, D-SNPs can make it simpler for members to navigate the health care system. This includes preventive care, which may help manage chronic conditions and treat health problems earlier.

D-SNPs encourage everyone involved in caring for a member – including primary care doctors, specialists, hospitals and care managers – to work together, which can help support members’ health as well as their experience with the health care system.

With a UnitedHealthcare Dual Complete plan, they may be eligible for:

• $0 copays on covered prescriptions¹
• $0 copays for routine covered dental services.
• $0 hearing exam plus coverage for hearing aids²
• $0 eye exam plus coverage for designer eyewear³
  

UnitedHealthcare Dual Complete members may also get a monthly credit to help pay for healthy food, over-the-counter products and utility bills⁵ with their UnitedHealthcare UCard®.

What’s more, people eligible for a D-SNP may be eligible for $0 monthly plan premiums.⁴

To find out if a D-SNP is available in your area, you can check out the Plan Finder on Medicare.gov. After entering some personal information, the tool will show you a list of private Medicare plans available in your zip code. Check to see if any of them include “Dual Special Needs Plan” in their name.

If you’d prefer to talk to someone about your options, a trained insurance counselor through the State Health Insurance Assistance Program (SHIP) could be a great option. Or reach out to a licensed insurance agent in your area who can meet in person or over the phone to determine whether a D-SNP is a good fit.

Visit getdual.com or call 1-800-560-5932 / TTY 711 to learn more about UnitedHealthcare Dual Complete. People who qualify for a dual plan can enroll or switch to a new plan at certain times throughout the first nine months of the year, not just during the Annual Enrollment Period.