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If you are enrolled in both Medicaid and Medicare at the same time, you may qualify for a Medicare Advantage Dual Eligible Special Needs Plan (D-SNP). This type of plan comes with extra benefits and lower costs to better accommodate the special health needs of those who qualify.
The specific benefits of any plan will vary based on where you live and what you qualify for. Because they are designed for people with special health needs or disabilities, D-SNPs may also offer coordination between your many different doctors and specialists.
Before enrolling in a D-SNP, you’ll need to be enrolled in both Medicare and Medicaid.
You may be eligible for Medicare if you are a US citizen or permanent legal resident for the last five years. You must also be one of the following:
To find out if you qualify for Medicaid, contact your state’s Medicaid office. Each state’s requirements will be different, but will most likely consider your:
Finally, there are certain times of year when you’ll become eligible to enroll in a D-SNP.
You can enroll in a D-SNP through your current insurance provider, your local state agency, or through a trusted Medicare broker. You’ll simply need your Medicare ID and your Medicaid ID.
If you have received disability insurance payments from Social Security or the railroad retirement board for 24 consecutive months, you will be eligible for Medicare at the beginning of your 25th month.
Generally, your Original Medicare Part A and Part B coverage is effective at the start of month 25 on disability, unless an exception applies. If you choose, you can enroll in more coverage through a private insurance company. You can pick a plan three months before, the month of, and three months after your 25th month of receiving Social Security.
Generally, you will enroll automatically. You should get your Original Medicare card and details in the mail three months prior to month 25 on disability, unless an exception applies. If you get Social Security payments, your Part B premium will be paid from your balance once your coverage starts. If you choose, you can enroll in a Medicare Advantage plan with a private insurance company. You can pick a plan three months before, the month of, and three months after your 25th month of receiving Social Security.
If you miss your Original Medicare initial enrollment period, you can sign up for Original Medicare Part A and Part B during Medicare’s General Enrollment Period from Jan 1 – March 31 each year. If you sign up during this time, your coverage will start the month after you enroll. After enrolling, you may have an opportunity to choose additional coverage, such as a Medicare Advantage or Part D plan, depending on your eligibility for certain enrollment periods. If you delayed enrollment without qualifying coverage, you may have to pay late enrollment penalties.