Dual-eligible Special Needs Plans (D-SNPs) offer various health benefits to those who qualify for Medicare and Medicaid. D-SNPs combine the two plans along with additional support to create a well-rounded, very comprehensive plan.
These plans are a part of Medicare Advantage. And, because it’s also a Special Needs Plan (SNP), that means you will receive all of the coverage it has to offer for little to no cost to you.
The Coverage Includes
This coverage includes:
- $0 monthly premiums
- Care coordination
- Vision and hearing benefits
- Over the counter quarterly benefits
- Transportation benefits
- Telehealth services
- Gym memberships
- Part D coverage
However, to know if you should enroll in a D-SNP for this coverage, you must first know whether or not you qualify.
How to Qualify for a D-SNP
Generally, you may qualify for a D-SNP if you’re enrolled in both Medicare and Medicaid, often based on your income and/or disability status. Once you meet this requirement, you will be considered under a D-SNP plan based on one of these eligibility categories:
- Qualified Medicare Beneficiary (QMB)
- QMB (QMB+) Plus
- Specified Low-Income Medicare Beneficiary without other Medicaid (SLMB)
- Specified Low-Income Medicare Beneficiary with other Medicaid (SLMB+) Plus
- Qualifying Individual (QI)
- Qualified Disabled and Working Individual (QDWI)
- Other Full Benefit Dual Eligible (FBDE)
The Five Types of D-SNPs
Within the category of D-SNPs, there are five different types of provided coverage, one or more of which you may qualify for based on the above categories. These five include:
- All-Dual
- Full Benefit
- Medicare Zero Cost Sharing
- Dual Eligible Subset
- Dual Eligible Subset Medicare Zero Cost Sharing
There’s a lot of information to understand here. Let’s break this down with an example — say you fall under the Qualifying Individual (QI) category. You can now determine which of the five D-SNPs you qualify for. All QI’s are eligible for an All-Dual, Dual-Eligible Subset, and Dual Eligible Subset Medicare Zero Cost Sharing plan(s).
To make sure you understand which eligibility categories offer what coverage, here’s a list of the categories with their D-SNP options:
- QMB: All plans except Full Benefit
- QMB+: Eligible for all plans
- SLMB: All-Dual, Dual Eligible Subset, and Dual Eligible Subset Medicare Zero Cost Sharing
- SLMB+: All plans except Medicare Zero Cost Sharing
- QI: All-Dual, Dual Eligible Subset, and Dual Eligible Subset Medicare Zero Cost Sharing
- QDWI: All-Dual, Dual Eligible Subset, and Dual Eligible Subset Medicare Zero Cost Sharing
- FBDE: All plans except Medicare Zero Cost Sharing
FREE Medicare Help Is Just a Phone Call Away!
Your security and protection are important to us. When it comes to Medicare, we can help provide peace of mind with your insurance coverage. When you call us at 478-254-4209, you’ll speak with a local agent who will shop carriers for you. We’ll find the best plan for you and your family’s situation. When you’re ready to get started, contact Meservey & Associates.
