Dual-Eligible Special Needs Plans (D-SNPs), private Medicare Advantage plans, exclusively enroll Medicare-Medicaid dual enrollees. First operationalized in 2006 and popular among state Medicaid agencies, enrollment in integrated plans remains a challenge. CMS expects states to transition existing plans ...
2 To improve care for this population, the Centers for Medicare & Medicaid Services (CMS) has encouraged development of dual-eligible special needs plans (D-SNPs)—MA plans that exclusively serve dual-eligible beneficiaries, coordinate Medicare and Medicaid benefits, and, in some cases, manage ...
6 Like other MA plans, D-SNPs primarily finance supplemental benefits through rebates in MA’s competitive bidding system. Because most dual-eligible beneficiaries have no Medicare out-of-pocket costs, D-SNPs often include benefits such as dental care, rather than premium or cost-sharing ...
Medicare and Medicaid Dual-Eligible Special Needs Plan Enrollment and Beneficiary-Reported Experiences With Care doi:10.1001/jamahealthforum.2023.2957JAMA Health ForumMeyers, David J.Offiaeli, KendraTrivedi, Amal N.Roberts, Eric T.
"State Contracting with Medicare Advantage Dual Eligible Special Needs Plans: Issues and Options. Integrated Care Resource Center Technical Assistance Tool." Mathematica Policy Research and the Centers for Health Care Strategies: Washington, DC, and Prince...
You qualify for either Medicare or Medicaid but not both You do not receive Original Medicare benefits You live outside an eligible plan coverage area You have options If a D-SNP is not available in your area, there may be other Medicare Advantage plans that are a good fit for you. ...
As payers and policymakers continue to search for better strategies around dual eligible care and coverage, research like NORC’s helps highlight the successful strategies seen in Medicare Advantage plans.
plans inJanuary 2026. At that time, the selected plans will be responsible for supporting Ohioans who are eligible for both Medicare and Medicaid healthcare coverage in the 29 counties where MyCare Ohio is currently available. Statewide expansion of the program will follow as quickly as possible....
In 2023, health plans will be required to pay providers in full when dual eligible beneficiaries accrue enough cost-sharing to reach their out-of-pocket limit, even if Medicaid did not pay the total amount of cost-sharing. Current capitated payment policies benefit Medicare Adv...
ns' Performance.]]>CosgroveJamesC.EBSCO_bspGao ReportsU.S. Government Accountability Office. (2012). Medicare special needs plans: CMS should improve information available about dual-eligible plans' performance (GAO-12-864). Washington, DC: Author....