When it comes to Medicare and Medicaid, there are a lot of plan options to choose from – and for many members who qualify, enrolling in a Dual Eligible Special Needs Plan (D-SNP) is the best way to benefit from both programs.

But what exactly is a D-SNP? Who qualifies for it? And how can it offer extra benefits to you? In this article, we answer some of the most commonly asked questions about D-SNPs so you can make an informed decision to fit your needs.

What is a Dual Eligible Special Needs Plan (D-SNP)?

A Dual Eligible Special Needs Plan, or D-SNP, is a plan designed for people who qualify for both Medicare and Medicaid. These plans, like the Align DUALPartnership Plan , are designed for people who could use extra help since they can give members more coverage and an enhanced health care experience through their additional benefits.

Because D-SNPs are offered through a single insurance provider, all your care (medical, behavioral and social services) is coordinated seamlessly and may not carry any extra costs.

What are the benefits of a D-SNP?

Put simply, D-SNPs can manage costs more effectively than other plans.

D-SNPs offer joint coverage from both Medicare and Medicaid, which means members typically have lower out-of-pocket expenses. D-SNPs also cover premiums, deductibles and copays that would otherwise be paid separately under Medicare and Medicaid.

What are the additional benefits of an Align DUALPartnership Plan?

We named our D-SNP the Align DUALParternship Plan because we believe partnering you with the providers and services you need will empower you to live a healthy life. As a member of our D-SNP, you’ll have access to a personal care team that will work with your providers to develop a customized care plan and connect you to services outside of our health care network.

Additionally, when you enroll in an Align DUALPartnership Plan, you will receive a Healthy Benefits+ Card that comes pre-loaded with monthly or quarterly allowances for health-related expenses like dentures, bridges, eyewear, hearing aids, healthy food, over-the-counter products, utilities and transportation to and from a doctor or pharmacy.

Other Align DUALPartnership Plan benefits include:

• $0 copays for primary care and specialty visits
• $0 copays for prescriptions
• $0 copays for routine eye exams and lenses

Who is eligible to enroll in a D-SNP?

People who qualify for both Medicare and Medicaid are eligible for a D-SNP.

Medicare is health insurance for:

• People above the age of 65
• Certain people under 65 years old with a disability
• People of any age with certain special medical diagnoses or situations

Medicaid is for individuals who have limited income and are: *

• Above the age of 65
• A child under the age of 19
• Pregnant 
• Living with a disability
• A parent or adult caring for a child 
• An adult without dependent children (in certain states)

People over 65 years old may also qualify for Medicaid if they receive special state assistance or supplemental security income (SSI).

When can I enroll in a D-SNP?

If you are eligible for a D-SNP, you can enroll during the Medicare Annual Enrollment Period (AEP) from Oct. 15 to Dec. 7. You may be able to apply for a D-SNP outside of the AEP if you: 

• Are 65 and newly eligible for Medicare or have a qualifying disability
• Are retiring and losing your current coverage
• Have moved out of your current Medicare plan’s coverage area
• Receive Medicaid benefits

If you already carry both Medicare and Medicaid plans, you can enroll or switch to a D-SNP during the AEP or during a Special Enrollment Period (SEP) if you qualify for one. How should I choose a health care plan? To help you choose a plan, we have created an easy-to-use buyer’s guide for Dual Eligible Special Needs Plans . If you have more questions or would like additional information, we have local, licensed agents who provide free assistance (with no obligation to purchase). Call (866) 404-6597 (TTY: 711) Monday–Friday, 8 a.m.–8 p.m. local time for more information, or visit align.sanfordhealthplan.com/dual .

*For more information on Medicaid eligibility, please visit https://www.hhs.nd.gov/healthcare/medicaid/eligibility

Sanford Health Plan and Sanford Health Plan of Minnesota have HMO and PPO plans with a Medicare contract. Sanford Health Plan D-SNPs have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. Sanford Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex, or any other classification protected under the law. This information is not a complete list of benefits. Call (888) 605-9277 ( TTY: 711) for more information. If you need language services or information given in a different format please call (888) 278-6485 (TTY: (888) 279-1549). ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (888) 278-6485 (TTY: (888) 279-1549). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電(888) 278-6485 (TTY: (888) 279-1549). Our customer service lines are available 8 a.m. to 8 p.m. CST, 7 days a week, October 1-March 31 except on Christmas and Thanksgiving, and Monday through Friday all other dates except on federal holidays.