You can enroll in a D-SNP if you qualify for full Medicaid (QMB+, SLMB+ FBDE) based on standards established by the State of Michigan and federal requirements. Medicaid will provide assistance with Medicare cost-sharing and will also provide full Medicaid benefits. Your cost share is $0 when the service is covered by both Medicare and Medicaid. There may be cases where you have to pay cost sharing when a service or benefit is not covered by Medicaid.
You are eligible to join a Priority Health D-SNP if:
- You are enrolled in Medicare Parts A and B;
- You are eligible for full Medicaid benefits;
- You reside within the plan's service area in the lower peninsula of Michigan. The counties not included are Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, Macomb, St. Joseph, Van Buren and Wayne; and
- You are 21 years of age or older
If your category of Medicaid eligibility changes, your eligibility for these plans will change. You will have a 6-month grace period to regain full Medicaid eligibility and will continue to be covered under this plan. During this grace period, you will be responsible for a portion of the costs of your Medicare benefits.