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Dual-Eligible Special Needs Plan (D-SNP)
Learn about Dual-Eligible Special Needs Plans (D-SNP) for clients with Medicare and Apple Health (Medicaid) coverage.
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A Dual-Eligible Special Needs Plan (D-SNP) is a special kind of Medicare Advantage plan for dual-eligible individuals. A D-SNP combines Medicare and Apple Health (Medicaid) services under one managed care plan.
A dual-eligible individual has both Medicare coverage and Apple Health coverage. This includes physical and behavioral health care coverage.
If you are a dual-eligible client, Medicare is your primary coverage for your physical health care needs. You also have Apple Health as secondary coverage.
Dual-eligible clients also have behavioral health coverage through an Apple Health managed care plan. This is a Behavioral Health Services Only (BHSO) plan. Behavioral health includes mental health and substance use disorder treatment.
Enrolling in a D-SNP does not change what Medicare or Apple Health covers.
The primary benefit of a D-SNP is having one plan for your Medicare and Apple Health coverage. D-SNP coverage makes finding a provider easier, since providers only need to accept one plan.
A D-SNP also improves your care coordination. Being in a D-SNP makes it easier for your providers to make referrals and plan your treatment.
You may choose the same managed care plan for both D-SNP and BHSO coverage. If so, the plan covers both your physical health care and your behavioral health care needs.
Some D-SNP plans offer supplemental benefits in addition to what Medicare and Apple health covers. Please contact the plans for more information.
D-SNP enrollment is open to all dual-eligible clients. If your Apple Health coverage only includes Medicare cost-sharing, you can still enroll in a D-SNP.
The D-SNP Coverage Map shows which counties have D-SNPs coverage.
The D-SNP Coverage Matrix shows which D-SNP is in each county. In some counties, managed care plans have only D-SNPs. In other counties, they have both D-SNPs and BHSOs.
Please consult with your providers to see which plans they accept. You can also contact the plans to see if your providers are in their networks.
You cannot enroll in both a D-SNP and a Health Home program. Enrollment into a D-SNP will disenroll you from your Health Home program. For more information on the Health Home program, see the Health Home page.
|Community Health Plan of Washington||
Current members: 1-800-942-0247
Prospective members: 1-800-944-1247
|Coordinated Care of Washington (WellCare)||
Current members: 1-833-444-9089
Prospective members: 1-866-527-0056
|Molina Healthcare of Washington||1-866-403-8293|
|UnitedHealthcare Community Plan||1-855-273-4568|
If you enroll in a D-SNP, your BHSO plan will still cover your behavioral health care needs.
You may wish to change your BHSO plan to be the same plan as your D-SNP. You can also choose one plan as your D-SNP and another plan as your BHSO. It is up to you and your providers to choose which plans work best for your healthcare needs.
Contact Washington Apple Health (Medicaid) if you wish to change your Apple Health BHSO plan.
If you are dual-eligible American Indian/Alaska Native, you can:
- Enroll in an Apple Health BHSO, or
- Receive Apple Health behavioral health coverage without a managed care plan.
There are advantages and disadvantages to each, depending on your individual circumstances. Tribal health clinic and urban Indian clinic staff are very familiar with these options and can help you make this choice. Learn more about coverage for American Indian/Alaska Natives.