What is dual eligibility?

Dual eligibility refers to people who are dual eligible for Medicare and Medicaid (HUSKY Health) coverage. About 12.5 million Americans are considered dual eligible, according to CMS.

Most of these individuals are “full-benefit” dual-eligible, meaning they can receive the full range of Medicaid benefits that are not covered by Medicare, such as long-term services and supports. “Partial-benefit” dual-eligible individuals, however, are not eligible for full Medicaid benefits, but can get assistance paying Medicare premiums and out-of-pocket costs through the Medicare Savings Programs. People who are dual eligible have Medicare as their primary insurer.

What are D-SNPs?

A Dual Eligible Special Needs Plan, or D-SNP, is a type of Medicare plan for people who are dual eligible.

If a person is dual eligible, they can choose “traditional Medicare” or a D-SNP. Similar to a Medicare Advantage Plan, a D-SNP offers coordination of Medicare benefits. A D-SNP combines multiple coverages and organizes healthcare benefits.

When/How to Enroll

You must be enrolled in Medicare before joining a Medicare Advantage D-SNP. Several insurers offer D-SNPs.