Medicare Dual Eligible Special Needs Plans
(D-SNPs): Eligibility requirements

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 Priority Health Medicare service area – any of the 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 these plans 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 a portion of the costs of your Medicare benefits.