Individuals who are eligible for both Medicare and Medicaid can enroll in a Dual Eligible Special Needs Plan, or D-SNP. D-SNPs are a special type of Medicare Advantage plan with limited enrollment.
D-SNP enrollment has changed a little in recent years. Here’s what insurance agents need to know about serving the D-SNP market.
D-SNP by the Numbers
Many people may be eligible for both Medicare and Medicaid. However, they just may not be aware of it.
The Medicaid program provides health coverage to 7.2 million low-income seniors and 4.8 million people with disabilities who are also enrolled in Medicare. These two groups of individuals are “dually eligible” and gain support from both programs.
Many plans cater to this market. According to KFF, there are 598 D-SNP plan options for 2021. This is an increase from 2020, when there were 540 D-SNP plans.
There are significantly more D-SNP plans than other types of Special Needs Plan. For 2021, there are 203 Chronic Condition Special Needs Plans and 174 Institutional Special Needs Plans.
All D-SNP plans offer the same basic benefits that are required by Medicare. These plans are also required to provide prescription drug benefits. Some offer additional benefits, as well, so it is important for enrollees to compare their plan options carefully.
The Current Enrollment System
In the past, dually eligible individuals were given continuous enrollment, allowing them to switch plans during any month of the year. Starting in 2019, this changed. Now dually eligible individuals can make a change to their plan with one election per quarter, for the first three quarters of each year.
Dually eligible individuals can switch, drop or join a plan once during each of the following three periods, and the changes will go into effect on the first day of the next month:
- January to March
- April to June
- July to September
This new system means that dually eligible individuals who want to switch plans during the fourth quarter need to participate in the annual election period, and their plan selections won’t go into effect until January 1. If they miss the annual election period, they will need to wait until the January-March D-SNP SEP to make a new selection.
The Impact of COVID-19
The current pandemic has made things difficult for many low-income seniors. People in this population may not have access to computers and the internet at home, and in many places around the country, libraries and other places where seniors could normally go for help have been closed. At the same time, securing good health care is especially critical.
This means that serving the D-SNP market may be especially hard right now, but it is also extremely important. Reach out to this market and be ready to assist while practicing social distancing.
Watch the WAP Calendar of Events for more in-depth D-SNP training coming in 2021. We will cover available plans and how to find D-SNP leads.