Are you having trouble selling to your clients with low budgets? Some beneficiaries are eligible for D-SNP, a combination of Medicare and Medicaid.
Special Needs Plans (SNPs) are reserved for those with special medical needs or chronic illnesses. They are also available for those living in a skilled care facility. D-SNPs, or Dual-Eligible Special Needs Plans, are for SNP beneficiaries who are eligible for both Medicare and Medicaid and receive benefits from both.
We’ve simplified the CMS guidelines for eligibility below:
Much like ACOs (Affordable Care Organizations), FIDE SNPs were created under the ACA to provide Medicare and Medicaid coordination under one organization. FIDE SNPs are specifically designed to provide all care for dual eligible beneficiaries. Organizations who want to be a FIDE SNP must have an approved CMS contract through their state Medicaid office. They must follow strict guidelines that CMS sets which aid with enrollment, communications, and grievance and appeals.
Although it is always important to place care and coverage above finances, make sure your clients are exposing their true financial capabilities so that you can help them determine if they are eligible for D-SNPs.