Dual Special Needs Plans (D-SNPs)

Together, we’ll explore your coverage options and find a solution that works for you.

Dual Eligible Special Needs Plans

Strategic Measures provides extra support for people who qualify for both Medicare and Medicaid.

Understanding Dual Eligible Special Needs Plans

If you have both Medicare and Medicaid, you may be eligible for a Dual Eligible Special Needs Plan, also known as a D-SNP. These plans are designed to coordinate care and provide additional benefits for individuals with complex needs due to limited incomes, and, in some cases, disabilities and/or chronic conditions..


D-SNPs help coordinate the coverage and policies of the two types of coverage, offering a more streamlined experience and extra support at little to no cost.


Two hands clasped together, possibly offering comfort or support.

What Is a Dual Eligible Special Needs Plan?

A Dual Eligible Special Needs Plan is a type of Medicare Advantage (Part C) plan that is specifically designed for people who are “dual eligible”—meaning they qualify for both Medicare and Medicaid.

These plans combine your Medicare coverage (hospital and medical) with Medicaid support and add extra benefits to help you stay healthy and independent.

Key Features of D-SNPs

D-SNPs are tailored to meet the unique needs of people with limited income, and, in some cases, disabilities and/or chronic conditions. Here’s what these plans typically include:


$0 or low-cost premiums


D-SNPs, like other Medicare Advantage plans, may have a monthly premium. For dual eligibles who qualify for full Medicaid benefits, the State usually covers the D-SNP monthly premium, and often also covers the Medicare Part B premium. For partial dual eligibles, some States pay the Medicare Part B premium, but very few states pay the D-SNP premium, if there is one. However, if there is a premium, it is usually quite low.


Coordinated care & case management


Get help managing appointments, prescriptions, specialists, and ongoing care.

Extra benefits beyond Original Medicare, such as:

  • Dental, vision, and hearing services

  • Over-the-counter (OTC) items and healthy food cards

  • Transportation to medical appointments

  • Fitness programs

  • Telehealth and wellness services

Prescription drug coverage (Part D)


D-SNPs include comprehensive drug coverage with low or no copays.

Who Qualifies for a Dual Eligible Special Needs Plan?

You may qualify for a D-SNP if:


  • You are enrolled in Medicare Part A and Part B,


AND

  • You receive full Medicaid benefits or partial Medicaid assistance (the Medicare Savings Plan, like QMB, SLMB, or QI programs).


AND


  • You live in the D-SNP's service area.


Some plans may have additional requirements, such as having specific chronic conditions.

Why Choose a D-SNP?

If you qualify, a D-SNP can help you:


  • Simplify your healthcare by combining multiple benefits into one plan.

  • Save money with reduced costs for doctor visits, hospital stays, and prescriptions.

  • Access personalized support with care managers who can help coordinate your treatment and services.

  • Enjoy extra services that improve your quality of life and help you stay independent.

Need Help Understanding Your Options?

Choosing the right plan can be overwhelming, but you don’t have to figure it out alone. A licensed insurance agent can walk you through:


  • Whether you qualify

  • Which D-SNPs are available in your area

  • What benefits are included, depending on what level of Medicaid benefits you have

  • How to enroll and start using your plan


  • Whether and when you can switch from one D-SNP to another, or leave a D-SNP to go back to Original Medicare and join a Prescription Drug Plan.

Dual Eligible Special Needs Plans are more than just insurance—they’re support systems built around you.


If you or a loved one qualifies, it’s worth exploring these plans and taking advantage of everything they have to offer.