Questions about Dual Eligible Special Needs Plans?

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.

To be dually eligible means that you qualify for both Medicare and Medicaid at the same time. Learn more about dual eligibility.

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 (QMB+, SLMB+, FBDE);
• 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.

Learn more about eligibility requirements.

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 are available in all 68 counties in Michigan’s Lower Peninsula. View the Priority Health Medicare service area.

You can view and search for drugs covered by Priority Health D-SNPs using the Approved Drug List.

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:

*Members must receive Extra Help (LIS) to receive this benefit.

You can enroll in a D-SNP during the Annual Enrollment Period, Open Enrollment Period or with a qualifying Special Enrollment Period. If you already have Medicaid and Medicare, you may qualify for a D-SNP. Learn more about eligibility For questions about eligibility and enrollment, give us a call at 888.379.0018 (TTY 711) from 8 a.m. to
8 p.m., seven days a week.