Questions about Dual Eligible Special Needs Plans?
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Frequently asked questions
Medicare is a federal program that provides health care coverage to people 65 and older and some people with disabilities.
Medicaid is a federal- and state-run government program that provides health care coverage for people with qualifying income. The federal government program provides Medicaid funding and resources to each state, which design and run their own Medicaid programs.
Medicare and Medicaid have different missions. Medicare provides health care coverage for people 65 and older and with certain disabilities. Medicaid provides health care coverage for people of all ages who don’t earn enough income to cover their health care costs. Learn more about Medicare and Medicaid.
A Dual Eligible Special Needs Plan, or D-SNP, is a Medicare plan for those who are eligible for both Medicare and full Medicaid coverage. If you’re 65 or older with a qualifying income, you may be eligible for a D-SNP.
People who are eligible for both Medicare and Medicaid are eligible for a D-SNP.
You qualify for a Priority Health D-SNP if:
- You’re currently enrolled in Medicare Parts A and B;
- You’re currently eligible for full Medicaid benefits;
- You live in the Priority Health Medicare service area (all 68 counties in Michigan’s Lower Peninsula); and
- You are 21 years of age or older.
With a D-SNP, your Medicare and Medicaid coverage work together to get you more care for less cost. Plus, D-SNPs are no-cost as long as you have and maintain full Medicaid coverage.
See the supplemental benefits section below to learn more.
First, you’ll need to provide your ZIP code to make sure you live within the Priority Health Medicare service area.
Your ability to enroll is based on verification that you are eligible for both Medicare and full Medicaid assistance. If for some reason you don’t qualify or your enrollment isn’t accepted, we’ll notify you right away.
Before you enroll, have your red, white and blue Medicare card ready or your letter from the Social Security Administration about your entitlement. You'll also need your Medicaid ID number.
Priority Health D-SNPs will provide supplemental benefits to its enrollees. These are extra benefits that are available to Medicare Advantage enrollees. They’re not covered under Medicare Part A and Part B. They include:
|Medication therapy management||
|Diet and nutritional education||
Routine vision, dental and hearing
|Behavioral health services||Online mental aptitude training|
|End-of-life support services||Companion care|
|In-home safety assessments||Acupuncture and routine chiropractic care|
|Community-based services and partnerships||Fitness membership|
|Home-delivered meals after inpatient stay||Personal Emergency Response System (PERS device)|
|Transportation for 30 one-way trips to or from health related locations|
*Members must receive Extra Help (LIS) to receive this benefit.