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

A Dual Special Needs Plan (D-SNP) combines Medicare and Medicaid coverage for people who are eligible for both. You may also see D-SNP plans referred to as Medicare-Medicaid Coordinated Plans (MMCP). Here is a brief overview of who is eligible for D-SNP plans in Idaho, as well as what benefits are included in Blue Cross of Idaho’s True Blue Special Needs Plan (HMO D-SNP).

young woman with a man in a wheelchairWho can get a D-SNP plan?

Eligibility for these plans can vary from state to state. If you are an Idaho resident, you qualify for a D-SNP plan if you are:

  • At least 21 years old
  • Living in the health plan’s D-SNP service area (here’s Blue Cross of Idaho’s plan service area)
  • Eligible for Medicare Part A
  • Enrolled in Medicare Part B
  • Enrolled in Enhanced Medicaid

What coverage do I get with a D-SNP plan?

With a Blue Cross of Idaho D-SNP plan, the benefits for your Medicare and Medicaid coverages will be coordinated for you, which will help you get the most out of your benefits. You will get one member ID card that you can use to manage both your Medicare and Enhanced Medicaid benefits, making it easier to use your benefits.

When you have a D-SNP plan, your Medicaid and Medicare coverages include:

  • Most Medicaid benefits, and Aged and Disabled (A&D), if authorized by the Idaho Department of Health and Welfare
  • Medicare Part A, which includes inpatient care at hospitals, skilled nursing facilities and hospice facilities
  • Medicare Part B, which includes outpatient care from doctors and other healthcare providers
  • Medicare Part D, which is Medicare’s prescription drug coverage (here’s a list of covered drugs under Blue Cross of Idaho’s True Blue Special Needs Plan)

What other benefits come with a D-SNP plan?

With a Blue Cross of Idaho True Blue Special Needs Plan (HMO D-SNP), you have additional benefits, including:

  • No monthly premium, no deductible and no Part D deductible
    Note: There is no premium or cost to join a D-SNP plan, but if you currently have a share of cost for waiver services or pay a premium for Part D prescription drugs, these costs will stay the same.
  • Access to a health plan’s network of providers
  • Supplemental dental, vision and hearing benefit
  • Additional benefits, such as:
    • Gym memberships
    • Companion services
    • Meal service
    • Allowance for over-the-counter medicines and transportation services

Please note that additional benefits for D-SNP plans may vary depending on which health insurance company is offering the plan.

D-SNP personal care coordinators

If you are enrolled in Blue Cross of Idaho’s True Blue Special Needs Plan (HMO D-SNP), you have access to a care coordinator, who can serve as your personal healthcare advocate to help you navigate your plan and care. Care coordinators can work with your family, doctors and other medical providers to make sure you get the right care.

Here are a few ways a care coordinator can help you:

  • Connect you with community resources
  • Provide education about your plan and benefits
  • Help you get prior authorizations for healthcare services
  • Develop a care plan tailored to your personal needs

Care coordinators provide individual support throughout the healthcare journey, which can improve your overall health and feeling of wellbeing.

For more information

For more information on Blue Cross of Idaho’s D-SNP plan, called the True Blue Special Needs Plan (HMO D-SNP), visit our Medicare and Medicaid plans page. You can also watch our What is D-SNP? video for more information.

 

Posted: July 12, 2023

Updated: January 17, 2024

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Idaho Medicaid pays the Medicare Part B premium for full-benefit dual-eligible members. This plan is available to full-benefit dual-eligible beneficiaries who are at least 21 years of age, live in our service area, and receive medical assistance from Medicare and Idaho Medicaid.

Blue Cross of Idaho Care Plus, Inc. is a HMO D-SNP health plan with Medicare and Idaho Medicaid contracts. Enrollment in Blue Cross of Idaho Care Plus, Inc. depends on contract renewal.

©2024 Blue Cross of Idaho Care Plus, Inc. (“Blue Cross of Idaho Care Plus”), an Independent Licensee of the Blue Cross Blue Shield Association, with services provided by Blue Cross of Idaho Health Service, Inc.

To file a marketing complaint call Medicare at 1-800-MEDICARE or Blue Cross of Idaho Care Plus, Inc. at 1-888-495-2583 (TTY:711).  It is important to provide an agent or broker name with your complaint.