Dual Special Needs Health Plans

Posted at 12:08 PM, Oct 04, 2018

According to the Center for Medicare & Medicaid Services (CMS), 80 percent of people eligible for a Dual Special Needs health plan (DSNP) are NOT enrolled in one[i]. With Annual Enrollment right around the corner, it’s important that people who qualify know that they may be missing out on additional benefits that a DSNP - or “dual” plan - can offer.  Yet navigating health plan offerings can be challenging, so it’s important for consumers to understand their choices and whether they qualify for more benefits.

By combining Medicare benefits for people with financial need (or on Medicaid), consumers may be eligible to enroll in a dual plan that offers additional benefits such as dental, hearing and vision coverage. With a dual plan, recipients may also be eligible for additional prescription drug coverage, along with more doctor and hospital choices. All of these additional benefits may come at no additional cost.

A Dual Special Needs Plan is a special type of Medicare Advantage plan that provides health benefits for people who could use some extra help because of disabilities, health conditions or age. More than 2 million people were enrolled in a DSNP plan in 2017, which represents 3 percent of all people enrolled in Medicare[ii].

The Annual Enrollment period, when health plan benefits are often top of mind for consumers, is a great time to consider a dual plan. However, people eligible for a dual plan have additional Special Election Periods available to change plans outside of the Annual Enrollment Period.

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