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Do you qualify for a Dual Eligible Special Needs Plan?

A Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) is for those who qualify for both Medicare and Medicaid.

If you qualify, your state will cover some of Medicare's cost, depending on the state and your eligibility.

Let's take a look at these plans and how they can benefit someone who is eligible.

Do I qualify for a Dual Eligible Special Needs Plan?

Anyone who is eligible for Medicare and Medicaid is eligible for a D-SNP.

According to Centers for Medicare and Medicaid Services, the Medicaid eligibility categories encompass all categories of Medicaid eligibility including:

  • Full Medicaid (only)

  • Qualified Medicare Beneficiary without other Medicaid (QMB only)

  • QMB Plus

  • Specified Low-Income Medicare Beneficiary without other Medicaid (SLMB Only)

  • SLMB Plus

  • Qualifying Individual (QI)

  • Qualified Disabled and Working Individual (QDWI)

States may have different eligibility, so be sure to talk with a licensed Medicare insurance agent to check your state's rules.

What does a D-SNP cover?

Medicare Advantage plans provide the same basic coverage that Original Medicare does, but with some added benefits that may include:

  • Dental

  • Vision

  • Hearing

  • Prescription drugs

  • Discounted over-the-counter medication, vitamins, blood pressure monitors

  • Chiropractic

  • Acupuncture

  • Fitness center memberships/classes

D-SNPs may also include transportation to health care visits and the pharmacy as well as meal programs. Again, these are all dependent on where you live and the plans that are available to you.

The distinct advantage of these plans are that they offer extra benefits at, typically, no extra cost.

Don't worry about losing the benefits you already get with Medicaid. Nothing changes on that front.

If you want to check to make certain you qualify for one of these plans, feel free to give us a call at (423) 240-0794. You can also send us a message by clicking here.


© 2023 by Billings & Company, LLC.

109 Jordan Dr., Ste B, Chattanooga, TN 37421

Tel: 423-240-0794


Medicare has neither endorsed nor reviewed this information.

Not connected or affiliated with any United States Government or State agency.


Calling this number will direct you to a licensed Agent/Broker.