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.
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.
See if a D-SNP Plan is right for you.
- Read the frequently asked questions to learn more about D-SNPs.
- Check what D-SNPs are available in your county and what Medicaid plans they accept. (Excel)
- Check whether your prescription drugs are covered by the plan on Medicare.gov.
- Call the plan or search their website to check whether your providers are in-network.
- Get free and unbiased help with Medicare from the Wisconsin State Health Insurance Assistance Program (SHIP).
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.