What a D-SNP is
D-SNP stands for Dual Eligible Special Needs Plan. It is a type of Medicare Advantage plan made for people who have both Medicare and Medicaid. The Medicare.gov page on Special Needs Plans lists it as one of three SNP types.
SNPs include care coordination. They tailor their benefits, provider choices and drug lists to the group they serve. They cover the same Part A and Part B benefits that all Medicare Advantage plans cover, and they may cover extra services.
Drug coverage is built in
All SNPs must provide Part D drug coverage. That means you get your medical and drug coverage in one plan. If you also receive Extra Help, the plan applies it.
You do not add a separate drug plan to a D-SNP. Read about Extra Help to see how the help may work.
Who can join
Medicare.gov says you need Part A and Part B and must live in the plan's service area. You must also meet the rules for that type of SNP. For a D-SNP, that means you have both Medicare and Medicaid.
CMS says D-SNPs enroll people eligible for both Medicare and Medicaid. Its D-SNP page explains the groups. You can only stay enrolled while you continue to meet the plan's conditions.
What to check before you join
D-SNPs differ from one plan to another. Ask these questions.
- Are my doctors, specialists and hospital in the network?
- Does the plan work with my Medicaid coverage, and who is my care coordinator?
- Which extra benefits are included, such as dental, vision, hearing or rides?
- Are my medicines on the drug list?
- Does the plan charge a premium? Medicare.gov says most costs are covered if you have Medicare and Medicaid, but check with your Medicaid office.
Plans are not the same in every county
Insurance companies decide where they offer SNPs, so plans may differ by county. Brick residents may see a different list from someone in another part of the state. Ask an insurance professional to check which D-SNPs are available at your address.
Changing plans during the year
People with Medicaid or Extra Help may have extra chances to change plans during the year. The rules for these windows have changed in recent years. Check with Medicare.gov, SHIP at 1-800-792-8820, or an insurance professional before you act, because joining a new plan can affect your Medicaid benefits.
Dual Eligible D-SNP plans in Brick, NJ: practical tips
If you are on NJ FamilyCare, call your Medicaid plan before you switch Medicare plans. The two need to work together. Ask whether your doctors accept both.
Bring your Medicare card, your Medicaid card and your medicine list to the call. See our page on NJ FamilyCare ABD for how Medicaid works with Medicare.
Keep reading
This page is part of the NJ Help Paying for Medicare library, inside our Medicare insurance guide for Brick, NJ. Related pages:
Unfamiliar word? Check the Medicare glossary.
Ask whether a D-SNP fits your situation
These plans are not available to everyone. An insurance professional can look at the plans available where you live and explain whether one may fit.
Frequently Asked Questions
What does D-SNP stand for?
It stands for Dual Eligible Special Needs Plan. It is a Medicare Advantage plan for people who have both Medicare and Medicaid.
Does a D-SNP include drug coverage?
Yes. All Special Needs Plans must include Part D drug coverage.
Can anyone with Medicare join a D-SNP?
No. You need both Medicare and Medicaid, you must live in the plan's service area, and you must meet the plan's rules.
Do D-SNPs cost extra?
It varies by plan. Medicare.gov says most costs are covered if you have both Medicare and Medicaid. Check with your Medicaid office.
Can I use any doctor with a D-SNP?
Not always. Some plans use networks. Ask whether your doctors and hospital are included.