Comparing health plans. Choosing between benefit options. Confirming your eligibility. Navigating all the paperwork. Enrolling in a Dual Eligible Special Needs Plan (D-SNP) — or any health plan — can be a long and confusing process.

Fortunately, there are some tried-and-true ways to make it easier. Here’s a handy guide to help walk you through enrollment. We want to help make it as simple as possible to get the benefits and services you may need.  

Step 1. Make sure you qualify 

To enroll, you need to be eligible for both Medicare and Medicaid. That’s where the “Dual” in Dual Eligible comes from.

How do you know if you qualify for both Medicare and Medicaid?  

In general, you’re eligible for Medicare if you’re over age 65. You may be eligible earlier if you have a disability or certain conditions like end-stage renal disease.  

If you’re already on both Medicare and Medicaid, then you automatically qualify. All you need to do is provide proof of both your Medicare and Medicaid cards.  

Not on Medicaid and don’t know if you qualify for it? The rules for eligibility rules vary by state. Visit Medicaid.gov/eligibility and select your state to learn more. 

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Step 2. Research the available options in your area  

There are a lot of different plans out there. You’ll want to compare them based on cost, coverage and benefits. This can get confusing, so it’s another good time to get help from a licensed agent.  

Another option: Check out the website of the health plan you’re interested in. For example, Aetna has a free online tool that makes it easy to search for and compare plans in your service area that may fit your needs. All you need is your ZIP code to get started. 

To see if you qualify, talk to a licensed Aetna agent for free by calling
1-844-514-8291 (TTY: 711). Agents are available:

• 8 AM to 8 PM, 7 days a week, local time, October 1 to March 31

• 8 AM to 8 PM, Monday–Friday, local time, April 1 to September 30 

Other questions to ask before you enroll in a D-SNP:* 

• Are my current doctors in my plan’s network? 
   
• Can I easily get to the plan’s doctors, hospitals and other facilities? 
   
• Does the plan provide any coverage for out-of-network providers? 
   
• Do I need a referral to see a specialist? 

• Are my drugs on the plan’s formulary (drug list)? 

A licensed agent can help you answer these and other important questions. 

Step 3. Make sure it’s the right time to enroll  

There are several enrollment periods:

Initial Enrollment Period (IEP): This enrollment period is only available when you first become eligible for Medicare. Your IEP is the 7-month period that begins three months before your 65th birthday, includes your birthday month and ends three months afterward. There’s an exception: if your birthday falls on the first of any month, your 7-month IEP begins and ends one month sooner.

Annual Enrollment Period (AEP): The Annual Enrollment Period for health insurance plans runs every year from October 15 to December 7. During this time, you can pick a new D-SNP (or any Medicare Advantage plan), switch from Original Medicare to Medicare Advantage, or change your Part D coverage.

Open Enrollment Period (OEP): This occurs annually from January 1 to March 31. It allows beneficiaries who are already enrolled in a Medicare Advantage plan to make certain changes to their coverage.
 
Special Enrollment Period (SEP): There may be other times when you can enroll in a D-SNP. This can include if you move, or if there’s a disaster declared by FEMA.  Additionally, a SEP is available three months after you begin Medicaid coverage. And a SEP is available for Full Benefit Dual Eligible (FBDE) individuals to align Medicaid and Medicare coverage so they’re provided by the same insurance company. To check your eligibility for a SEP, call a licensed Aetna agent at 1-844-514-8291 (TTY: 711) between 8 AM and 8 PM, local time, 7 days a week.  

Step 4. Complete the enrollment process 

It’s never a bad time to contact a licensed insurance agent about the enrollment process. Once you have a plan in mind, they can answer questions, help you better understand the process and send you an enrollment application during Initial or Annual Enrollment Periods. They may ask to see a copy of your Medicaid card to verify that you’re eligible. If you’re enrolling in an Aetna plan, our licensed agents can help you complete the process for free.  

Step 5. Review your coverage every year 

It’s a good idea to review your plan every year during the Annual Enrollment Period. That way, you can make sure that all your doctors are still in the plan’s network, and that all your drugs are still covered. If you’re not happy with your plan, you can switch. Just remember that it won’t go into effect until January 1 of the next year. 

*FOR QUESTIONS TO ASK BEFORE YOU ENROLL: Medicare Interactive. Questions to ask before enrolling in a SNP. Accessed July 28, 2025.

*FOR ENROLLMENT TIMING: National Council on Aging. What is a Dual Eligible Special Needs Plan (D-SNP)? November 30, 2022. Accessed July 28, 2025.

If you qualify for both Medicare and Medicaid, you may be eligible for an Aetna® Dual Eligible Special Needs Plan (D-SNP).

Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our DSNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. Plan features and availability may vary by service area. 

The benefit(s) mentioned are part of special supplemental benefits for the chronically ill (SSBCI). SSBCI conditions include but are not limited to: hypertension, hyperlipidemia, diabetes, cardiovascular disorders, and chronic lung disorders. Eligibility is determined by whether you have a chronic condition associated with the benefit(s). Standards and conditions vary for each benefit. Contact us to confirm the specific SSBCI condition requirements for the benefit(s) for this plan and determine your eligibility. This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to our website.

Participating health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. Out-of-network/non-contracted providers are under no obligation to treat plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. To send a complaint to Aetna, call the Plan or the number on your member ID card. To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week. If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance

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