Sponsored by UnitedHealthcare
Many of us start using our health plan early in the year — visiting doctors, filling prescriptions and managing care referrals — and quickly notice what feels easy or confusing.
The first few months of the year can be a learning curve.
Dual Special Needs plans
People with Medicare and Medicaid may be eligible for a Dual Special Needs plan (D-SNP), a type of Medicare Advantage plan offered by private companies approved through Medicare. With many plans available, it's important to know how yours works.
D-SNPs help coordinate your Medicare and Medicaid benefits, provide care coordination like help managing doctor visits, and may include more benefits than Original Medicare such as dental care, gym memberships, rides to doctor visits and support paying for groceries and over-the-counter items.
This simple, five-question check-in from UnitedHealthcare is designed to help you better understand how your plan works.
1. Can you see the doctors you need?
Seeing trusted providers matters, especially if you manage ongoing health needs such as heart disease or high blood pressure.
- Confirm your primary care doctor, hospitals and clinics are in-network
- Review how virtual care works for your plan, if you use it
2. Are your prescriptions covered?
D-SNPs include Medicare Part D drug coverage, but plans may cover the cost of medications differently.
- Check that your prescriptions are covered and your pharmacy is in-network
- Understand any costs you may pay, such as a co-pay, for your medication
3. Are additional benefits working as expected?
D-SNPs may offer additional benefits beyond Original Medicare, such as dental care or rides to doctor visits for eligible enrollees. Some plans may offer help paying for healthy groceries and utility bills for eligible chronically ill enrollees with a qualifying condition.
- Learn which additional benefits you may qualify for
- Know how to access benefits when you need them
4. Is it clear how to get help?
D-SNPs provide care coordination to help members support their overall health. Care coordinators may help explain your benefits, remind you of appointments, and connect you to services that support your health.
- Know how to get plan support when you need it
- Consider if you receive clear and consistent information
5. Are you eligible?
Eligibility for Medicaid varies by state, and D-SNPs are for people with both Medicare and Medicaid coverage. Life changes such as changes in income or disability status can affect eligibility.
- Read any notices from your Medicare and Medicaid programs
- Complete any steps required to maintain coverage
Where to go from here
Make time for your check-in now so that you're ready to use your plan when you need it most.
It can be hard to keep up with coverage. That's why we're here to help you understand how D-SNPs work, so you feel confident using your plan all year long.
To learn more about D-SNPs, visit GetDual.com.
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This information is provided for educational purposes only and does not promote a specific Medicare plan or benefit. Benefits, features and/or services may vary by plan and location. Limitations, exclusions and network restrictions may apply.
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan's contract renewal with Medicare.
The healthy food and utilities benefit is a special supplemental benefit only available to chronically ill enrollees with a qualifying condition, such as diabetes, cardiovascular disorders, chronic heart failure, chronic high blood pressure and/or chronic high cholesterol, and who also meet all applicable plan coverage criteria. There may be other qualified conditions not listed. Contact us for details.
OTC, food and utilities benefits have expiration timeframes. Call your plan or review your Evidence of Coverage (EOC) for more information.
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