Medicare D-SNP: Eligibility requirements

You can enroll in this plan if you qualify for Full Benefits Dual Eligible (FBDE). Medicaid will provide assistance with Medicare cost-sharing. Medicaid also provides 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 the PriorityMedicare® D-SNP (HMO) plan if:

  • You are enrolled in Medicare Parts A and B;
  • You are eligible for full Medicaid benefits;
  • You reside within the Priority Health Medicare service area – all 68 counties in the lower peninsula of Michigan; and
  • You are 21 years of age or older.

If your category of Medicaid eligibility changes, your eligibility for this plan will change. You will have a 6-month grace period to achieve Medicaid redetermination and will continue to be covered under this plan. During this grace period, you will be responsible for the costs of your Medicare benefits, which will be the same as if you were on Original Medicare.