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What Is A Dual Special Needs Plan (D-SNP)?
A Dual Special Needs Plan is a type of Medicare Advantage (Part C) Plan designed for people who are eligible for both Medicare and Medi-Cal.
Types Of D-SNPs
A D-SNP offers convenient coverage that can make your healthcare more affordable. They typically cover all your medical costs and more – with low monthly premiums and $0 copays.
There are two different types of D-SNPs offered:
Full Dual Eligible
Full dual eligible means you receive full Medi-Cal benefits. Your Medicare Part A and B premiums and nearly all of your out-of-pocket costs may be paid based on the state's program.
Partial Dual Eligible
Partial dual eligible means you qualify for Medi-Cal but based on your income, you don't receive full medical benefits. You may have to pay some out-of-pocket costs for premiums and medical care.
What Are The Benefits Of A D-SNP?
D-SNPs offer broad coverage that combines Original Medicare Part A (hospital) and Part B (medical) with complete benefits like these, all in one plan:
Over-the-counter items, groceries, and utilities
$0 Premiums
Most plans have $0 monthly premiums
$0 Copays
$0 prescription drug copays
Routine exams, plus allowances for eyewear and hearing aids
Rides for plan-approved services
Stay in shape with free access to SilverSneakers® gym membership
Smart Tip: Your D-SNP lets you keep all your Medi-Cal benefits. The plan coordinates your coverage between Medicare and Medi-Cal, so all your benefits are easier to access.
When To Enroll In A D-SNP Plan
You Don't Have to Wait
Once you've signed up for Original Medicare,‡ you can enroll in a Dual Special Needs Plan anytime if you have Medi-Cal or become eligible for Medi-Cal.
If you already have a D-SNP, you can switch your plan once per quarter from January 1 through September 30, and during the Medicare Annual Enrollment Period from October 15 through December 7 each year.
Other Special Needs Plans (SNPs)
A D-SNP is just one type of special needs Medicare Advantage plan. There are other SNP plans that may be a better fit for you.
C-SNP
Chronic Condition Special Needs Plan
YOU HAVE A CHRONIC CONDITION
These plans are designed for those who are eligible for Medicare and have a chronic or disabling condition like diabetes, heart conditions, lung disease, or kidney disease.
A C-SNP Medicare Advantage plan can offer access to providers who specialize in chronic conditions, plus provide better coverage for the prescription drugs used to treat them.
C-SNPs also have a dedicated care management team that helps members coordinate care and access providers who specialize in their condition.
I-SNP
Institutional Special Needs Plan
YOU NEED LONG-TERM CARE
These Medicare Advantage plans are for Medicare-eligible individuals who need care for 90 days or more from:
Note: Anthem offers I-SNPs only in California, Connecticut, Nevada, and Virginia.
If you don't qualify for any special needs plans, you may want to consider other Medicare Advantage plan options.
Learn Medicare Basics
Medicare doesn't have to be difficult. Our free Dual Special Needs Plan guide and Medicare articles help make things easier to understand.
Frequently Asked Questions About D-SNPs
If you have both Medicare and Medi-Cal, you may be eligible for a full or partial D-SNP depending on your income and other factors.
If you qualify for both Medicare and Medi-Cal, a D-SNP is probably your best choice. Most plans come with $0 premiums and $0 copays and provide other benefits like these:
- Dedicated care management
- Prescription drug coverage
- Depending on your plan, additional coverage for acupuncture, podiatry services, a free Personal Emergency Response System, allowances for groceries, over-the-counter health items, utilities, and more.
If you have Medi-Cal, you should always look at your D-SNP options first before you explore other plans. With $0 premiums and $0 copays, plus help with supplemental health and living expenses, a D-SNP could be your lowest-cost option. Also, depending on your state's Medi-Cal program, if you're receiving full Medi-Cal benefits, your true annual out-of-pocket healthcare costs could be close to $0.
No, not at all. A D-SNP lets you keep all your Medi-Cal benefits and coordinates them with your Medicare coverage. That way you can access all your benefits more easily.
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Anthem Blue Cross is an HMO plan with a Medicare contract. Anthem Blue Cross Life and Health Insurance Company is an LPPO plan with a Medicare contract. Anthem Blue Cross is an HMO SNP plan with a Medicare contract and a contract with the California Medicaid program. Enrollment in Anthem Blue Cross, Anthem Blue Cross Life and Health Insurance Company depends on contract renewal.