Dual Eligible Special Needs plans

Dual Eligible Special Needs Plans

Dual Eligible Special Needs plans (DSNP) are a type of Medicare Advantage plan for people who are eligible to receive both Medicare and Medicaid benefits.

You have to enroll in both Medicare Parts A and B before you can apply for a DSNP. You can sign up for Medicare three months before the month you turn 65 to three months after. Or you need to have a qualifying disability. 

To be eligible for Medicaid, your income and asset level has to be below a certain amount determined by the state you live in. 

What do Dual Eligible Special Needs Plans cover? 

It depends on your service area but, in general, DSNPs cover: 

  • Vision and hearing
  • Over-the-counter drugs
  • Transportation to and from healthcare visits
  • Gym memberships and classes
  • Prescription drug benefits
  • All of your Part A and B benefits

They typically come with no additional monthly premium! If you think you’ll qualify, be sure to call Expert Insurance Team and we can confirm and get you covered!

How to enroll in a Dual Eligible Special Needs Plan

You can enroll in a DSNP during your initial enrollment period. This is a seven-month period that starts three months before the month you turn 65 and ends three months after the month you turn 65. If you are becoming eligible because of receiving disability or certain railroad retirement benefits, it is after you have been receiving benefits from Social Security or the Railroad Retirement Board for 24 months

You can also sign up during the annual election period that spans from October 15 through December 7 each year. 

You may also be eligible for a special election period.

You can find out if you are eligible by speaking with a licensed Medicare agent, but here are some instances where you would be eligible: 

  • You move outside your current plan’s area
  • Suffered unintentional loss of coverage
  • Got married
  • Had a baby
  • You become eligible for Medicaid

Again, if you need help determining eligibility or want one of these plans, be sure to give us a call at 800-808-0209 or drop us a message by clicking here.