Medicare Plans for People with Medicaid: Dual Eligible Special Needs Plans

Dual Eligible Special Needs Plans (D-SNPs) can help coordinate your Medicare and Medicaid.

A Dual Eligible Special Needs Plan, also called a D-SNP, is a kind of Medicare Advantage plan for people who have both Medicare and Medicaid.

D-SNPs cover hospital, medical, and prescription costs all in one plan, with no or low costs. These plans have provider networks, which means that you must see doctors who are in-network (who accept your insurance) for the plan to help pay your medical bills.

D-SNPs work best when you are enrolled in the same company’s health maintenance organization (HMO) for your Medicaid. That way, the same company is providing both your Medicare and Medicaid coverage.

Medicare and Medicaid usually don't coordinate. Separate companies provide managed care for each plan.

Two unlocked puzzle pieces when Medicare and Medicare are not coordinated

If you have a Medicare D-SNP and Medicaid HMO or managed care organization (MCO) through the same company, Medicare and Medicaid benefits are coordinated.

Two locked puzzle pieces showing coordinated Medicare and Medicaid insurance

See if a D-SNP Plan is right for you.

Default enrollment notices

Members enrolled with an SSI Medicaid HMO who are getting Medicare for the first time may be enrolled with a Medicare D-SNP offered by the same HMO they currently have for their SSI Medicaid. This is called "default enrollment." Below are examples of default enrollment notices sent by D-SNP organizations.

 

Professionals can access D-SNP resources on the GWAAR Medicare Outreach and Assistance Resources webpage.

Last Revised: July 5, 2022