Medicare / Medicaid Education Session: Dual Special Needs Plans

A little departure from the typical podcast for a medicare Education Session, because I get a ton of questions about these SNP programs.


Some people are eligible to have both Medicare and Medicaid. These people are considered “dual eligible,” and they also qualify to enroll in a special kind of Medicare Advantage plan known as a Dual Special Needs Plan (D-SNP).

 What Is A Dual Special Needs Plan?

A Dual Special Needs Plan is a special kind of Medicare Advantage coordinated-care plan. It is an all-in-one plan that combines your Medicare Part A and Part B benefits, your Medicare Part D prescription drug coverage, your Medicaid benefits and additional health benefits such as vision, dental or fitness.

 Who Can Get A Dual Special Needs Plan?

 You can get a Dual Special Needs Plan if you meet the following qualifications:

 1.    You are eligible Medicare and Medicaid and have both.

2.    You have Medicare Part A and Part B.

3.    You live in the plan’s area.

 What Does A Dual Special Needs Plan Cover?

 Just like any other Medicare Advantage plan, a Dual Special Needs Plan will include coverage for Medicare Part A and Part B. It will also include Part D prescription drug coverage and extra benefits not provided by either Medicare or Medicaid.

 Examples of extra benefits a Dual Special Needs Plan may provide include:

•  Credits to buy health products
• Transportation assistance
• Care coordination via a personal care coordinator
• Personal emergency response system (PERS)
• Tele-health options such as virtual medical visits with your doctor
• Worldwide emergency coverage

 The extra benefits offered will vary by plan, provider and location.