If you qualify for both Medicare and Medicaid, you may have heard about something called a D-SNP. The name’s a mouthful—Dual-Eligible Special Needs Plan—but the idea behind it is simple: it’s a type of Medicare Advantage plan created specifically for people who have both types of coverage.
So what does that really mean for you? Let’s break it down.
What Does “Dual-Eligible” Mean?
“Dual-eligible” refers to individuals who qualify for both:
- Medicare – typically due to age or certain disabilities
- Medicaid – based on income and state-specific eligibility rules
You might have Medicare because you turned 65 or have a qualifying condition, and Medicaid because your income falls within your state’s limits.
If that’s you—you’re not alone. And there are plan options designed specifically to work with both coverages.
So, What’s a D-SNP?
A D-SNP is a Medicare Advantage plan that’s built for dual-eligible individuals. It’s designed to coordinate your Medicare and Medicaid benefits more smoothly.
Here’s the key idea: instead of having Medicare and Medicaid operate separately, a D-SNP helps streamline the way your coverage works together—one card, one plan, one source of support.
D-SNPs are available through private insurance carriers that are approved by Medicare. And while they follow Medicare rules, your eligibility and benefits may depend on your Medicaid status—which varies by state.
Who Can Enroll in a D-SNP?
To qualify for a D-SNP, you typically must:
- Be enrolled in Medicare Part A and Part B
- Have full or partial Medicaid eligibility through your state
Some plans are open to those with specific Medicaid levels (like QMB, SLMB, etc.). Others may require full Medicaid to enroll.
Also, you must live in the plan’s service area. Plans are offered at the county level, so what’s available in one ZIP code may not be in another.
Why Does Coordinating Coverage Matter?
Managing both Medicare and Medicaid can get tricky. You might find yourself bouncing between multiple coverage sources, not knowing who pays for what.
A D-SNP brings these pieces under one umbrella—helping make things simpler.
It can also make communication easier. Instead of calling two different agencies about your coverage, you can often go through a single plan representative.
That’s not about adding anything new. It’s about organizing what you already qualify for.
In Conclusion
A D-SNP isn’t for everyone—but if you’re eligible for both Medicare and Medicaid, it may be worth exploring. These plans are designed with your situation in mind.
Want to know if you qualify?
Find out if you’re eligible for a plan designed for those with both Medicare and Medicaid.
A licensed agent can help you check your eligibility and explore available options based on your ZIP code and Medicaid level.
