Ready to get more from your health plan?
Talk to a licensed agent today — it doesn’t cost a thing to learn more about Aetna® Dual Eligible Special Needs Plans!
How to enroll in a Dual Eligible Special Needs Plan, or D-SNP
Get step-by-step guidance on how to enroll in both Medicare and Medicaid, and qualify for a low- to no-cost D-SNP
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 D-SNP enrollment. We want to help make it as simple as possible to get the benefits and services you need.
Step 1. Make sure you qualify
To enroll in a D-SNP, you need to be eligible for both Medicare and Medicaid. That’s where the “Dual” in D-SNP 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 for a D-SNP. 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 vary by state. One of the easiest ways to find out if you qualify is to talk to a licensed agent. You can speak with a licensed Aetna® agent for free by calling 1-833-228-1297 (TTY: 711). Agents are available:
- 8 AM to 8 PM, 7 days a week, October 1 to March 31
- 8 AM to 8 PM, Monday-Friday, April 1 to September 30
An Aetna agent can help you through the entire enrollment process for free.
Step 2. Research the available D-SNP options in your area
There are a lot of different D-SNPs 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 for a D-SNP, talk to a licensed Aetna agent for free by calling
1-833-228-1297 (TTY: 711). Agents are available:
-
8 AM to 8 PM, 7 days a week, October 1 to March 31
-
8 AM to 8 PM, Monday–Friday, April 1 to September 30
An Aetna agent can help you through the entire enrollment process for free.
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.
It’s here — health care you can rely on!
To see if an Aetna Dual Eligible Special Needs Plan, or D-SNP, Medicare Advantage plan is right for you, call us at 1-833-228-1297 (TTY: 711) between 8 AM and 8 PM, 7 days a week.
Step 3. Make sure it’s the right time to enroll
There are four D-SNP enrollment periods:
Initial Enrollment Period: This enrollment period is only available when you first become eligible for Medicare. It starts three months before your 65th birthday and continues for seven months. If your birthday is on the first of the month, eligibility starts two months before you turn 65.
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 1-833-228-1297 (TTY: 711) between 8 AM and 8 PM, 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 D-SNP, our licensed agents can help you complete the entire process for free.
Enrolling in a health plan just got a lot easier
A licensed Aetna agent can help answer your questions and guide you through the enrollment process from start to finish — for free.
Schedule a call with a licensed Aetna representative today — it can’t hurt to learn more.
Step 5. Review your coverage every year
It’s a good idea to review your D-SNP 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.
If you qualify for both Medicare and Medicaid, you may be eligible for an Aetna® Dual Eligible Special Needs Plan (D-SNP).
If you're 65 or older and have diabetes or an eligible heart disease, you may qualify for an Aetna® Chronic Condition Special Needs Plan (C-SNP). C-SNPs are currently available in select counties in IL and PA.
You may be eligible for an Institutional Special Needs Plan (I-SNP) if you’ve lived (or plan to live) in a participating facility for 90+ days or you have Medicare Part A (hospital insurance) and Part B (medical insurance).
* FOR FULL VERSUS PARTIAL MEDICAID BENEFITS: Medicare Interactive. Enrolling in a SNP. Accessed September 24, 2024.
*FOR QUESTIONS TO ASK BEFORE YOU ENROLL: Medicare Interactive. Questions to ask before enrolling in a SNP. Accessed September 24, 2024.
*FOR ENROLLMENT TIMING: National Council on Aging. What is a Dual Eligible Special Needs Plan (D-SNP)? November 30, 2022. Accessed September 24, 2024.
Plan features and availability may vary by service area.
For members in California, New Jersey and New York FIDE plans: The benefits mentioned are part of special supplemental program for the chronically ill. Eligibility is determined by whether you have a chronic condition associated with this benefit. Standards may vary for each benefit. Conditions include Hypertension, Hyperlipidemia, Diabetes, Cardiovascular Disorders, Cancer. Other eligible conditions may apply. Contact us to confirm your eligibility for these benefits.
Eligibility for the Model Benefit or Reward and Incentive (RI) Programs under the Value-Based Insurance Design (VBID) Model is not assured and will be determined by Aetna after enrollment, based on relevant criteria (e.g., clinical diagnoses, eligibility criteria, participation in a disease state management program).
Nondiscrimination Notice | CA-Specific Nondiscrimination Notice
©2024 Aetna Inc.
Y0001_3737695_2025_M
3983913-01-01
