D-SNP Plans for Dual Eligible Beneficiaries

What Is a D-SNP?

A D-SNP is a Medicare Advantage plan for people who have both Medicare and Medicaid. It pulls both programs together, so you deal with one plan instead of two. It brings together the benefits of both programs and often include extra benefits to address the complex needs of dual-eligible beneficiaries.

What you qualify for changes by state and county. Most Idaho counties have D-SNP plans, but the choices and details differ by location.

Who Qualifies?

To enroll in a D-SNP, you must be enrolled in both Medicare and Idaho Medicaid. There are different levels of dual eligibility:

• Full dual eligible: Medicaid pays your Medicare premiums and most cost-sharing.
• Partial dual eligible: Medicaid pays some of your Medicare costs, but not all. These programs go by short names: QMB, SLMB, and QI.

Potential Benefits of D-SNP Plans

D-SNPs often offer benefits beyond standard Medicare Advantage, which may include:

• $0 or low monthly premiums (for fully dual-eligible members, eligibility varies)
• Over-the-counter (OTC) benefit allowances
• Non-emergency medical transportation
• Dental, vision, and hearing coverage
• Meal delivery after a hospital stay
• Care coordination and case management services

What you get depends on the plan and on your Medicaid level. Not everyone gets every benefit listed above.

Enrollment Periods for D-SNP

Signing up for a D-SNP works differently. Since January 2025, people with both Medicare and Medicaid get a monthly Special Enrollment Periods (SEPs): you can enroll into an integrated D-SNP that aligns with your Medicaid plan in any month, or switch back to Original Medicare with a standalone Part D plan in any month. (This replaced the old once-per-quarter rule.)