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Become an Aetna D-SNP member, and you can call our 24/7 Nurse Line to speak with a registered nurse, 24 hours a day, 7 days a week.
What is a D-SNP, or Dual Eligible Special Needs Plan?
A D-SNP combines benefits of both Medicare and Medicaid, plus offers added benefits and support for people who need it — learn more here now
No one should have to choose between having trustworthy health insurance and putting healthy food on the table. Unfortunately, it’s a common struggle for many Americans. If you’re one of them, you may be able to get help from a Dual Eligible Special Needs Plan, or D-SNP.
“A Dual Eligible Special Needs Plan is a type of health insurance plan designed for individuals who are eligible for both Medicare and Medicaid,” says Andy Friedell. He’s the chief operating officer of The Helper Bees, an aging-in-place platform. People who qualify for a D-SNP are “dual eligible.” They tend to have greater health care needs than others.
That's why D-SNPs have more complete benefits than other Medicare plans. For example, Aetna® offers D-SNPs that include dental, vision and hearing coverage. Aetna D-SNPs also give members allowances to make healthy living easier. And all Aetna D-SNP members get prescription drug coverage. The overall goal of a D-SNP: to deliver quality and efficient care at a low or no cost.
D-SNPs are available in 45 states and Washington, D.C. About 3.8 million Americans already have one.* Want to learn more about D-SNPs? Here’s a closer look.
About D-SNP medical and drug coverage
D-SNPs combine the benefits of a Medicare Advantage plan with the benefits of Medicaid into one health plan. With both plans together, you get more medical coverage.
“Medicare is a federal health insurance program that primarily covers individuals ages 65 and older, as well as some younger individuals with disabilities,” Friedell says. A Medicare Advantage plan includes four parts:*
1. Medicare Part A (hospital insurance). Part A covers:
- Inpatient care in hospitals
- Skilled nursing facility care
- Hospice care
- Home health care
2. Medicare Part B (medical insurance). Part B covers:
- Services from doctors and other health care providers
- Outpatient care
- Home health care
- Durable medical equipment. Examples include wheelchairs, walkers and hospital beds.
- Preventive services. Examples include screenings, shots, vaccines and yearly “wellness” visits.
3. Medicare Part C (Medicare Advantage or MA plans). Part C provides all your Part A and Part B coverage. It may also include Part D and/or additional coverage for things like vision, hearing and dental services.
4. Medicare Part D (Drug coverage). Part D covers the cost of prescription drugs as well as certain shots or vaccines.
Medicaid is a joint federal and state program. It provides health coverage to people with low incomes, disabilities or certain illnesses. With a D-SNP, Medicaid provides coverage to help pay for premiums, cost sharing and services not covered by Medicare.*
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More information about D-SNPs
All D-SNPs are different, but they all offer more coverage and benefits you wouldn’t normally get with a health plan. Aetna D-SNPs come with:
A dedicated care team. Care teams help you understand your benefits, coordinate doctor visits, manage your medicines and more. They help take the stress out of getting the care you need and deserve. And they work to save you time and money along the way.
Dental, vision and hearing coverage. Many Medicare and Medicaid plans can have little dental, vision and hearing coverage. But Aetna offers D-SNPs that include $0 copays on annual exams and yearly allowances for dental care, eyewear and hearing aids.
A $0 copay on covered Part D drugs at in-network pharmacies.
An Extra Benefits Card. This card comes pre-loaded with different monthly allowances or “wallets”. They can be used to help pay for approved items and services that help you stay well. The Extra Support wallet is the most flexible allowance on the card. You can use it to pay for:
- Healthy foods
- Over-the-counter (OTC) for select health and wellness items
- Rent or mortgage assistance
- Personal care items
- Utilities
- Transportation
- Pet care supplies
Still have questions about how D-SNPs work and what’s included? A licensed agent can help you answer those and other questions. You can speak with a licensed Aetna agent for free. They're available at 1-833-771-3597 (TTY: 711) 8 AM to 8 PM, 7 days a week, October 1 to March 31, and 8 AM to 8 PM, Monday through Friday, April 1 to September 30.
Who’s eligible for a D-SNP
To qualify for a D-SNP, you must be eligible for both Medicare and Medicaid. If you’re worried that switching to a D-SNP may cause you to lose your Medicaid coverage, rest easy: It won’t. Instead, think of it as upgrading your plan to add Medicare.
You must also be a U.S. citizen or have lived in the country for at least five years as a legal resident. And you must live in a D-SNP service area.
One of the easiest ways to find out if you qualify for a D-SNP? Talk to a licensed agent. A licensed Aetna agent can confirm your eligibility. And they can answer your D-SNP questions for free.
Checking your D-SNP eligibility just got a lot easier
A licensed Aetna agent can check your eligibility and guide you through the enrollment process from start to finish — for free. Schedule a call with a licensed Aetna agent today — it can’t hurt to learn more.
How to enroll in a D-SNP
If you are eligible, here’s how to apply for dual Medicare and Medicaid, or a D-SNP. The first step is to compare D-SNPs in your area based on cost, coverage and benefits, to find the right one for you. A licensed agent can be super helpful with this, too.
Another good idea is to 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 plans in your area. All you need is your ZIP code to get started.
Timing is also important. Fortunately, there are several periods during the year when you can enroll in a D-SNP.*
- Initial Enrollment Period. This starts three months before your 65th birthday and continues for seven months.
- Annual Enrollment Period. It runs from October 15 to December 7 every year.
- Three Special Enrollment Periods. They are January 1 to March 31, April 1 to June 30 and July 1 to September 30.
Help is here
If you have more questions about D-SNPs or need support with enrollment, you don't have to go it alone. Remember, a licensed Aetna agent can help you find the best Aetna plan for you. They can help you join when the time is right and complete the enrollment process. They'll also be there for future questions.
And that support doesn’t go away once you become a member. Aetna D-SNP members can call their care team for help coordinating their care. The Aetna Member Services team is available from 8 AM to 8 PM, 7 days a week. Plus, Aetna members can call the 24/7 Nurse Line to get answers to health questions from a registered nurse.
Want to learn more about D-SNPs and becoming a member? Check out these related articles and resources to get answers and support:
- How to enroll in a Dual Eligible Special Needs Plan, or D-SNP
- Medicaid vs. Medicare: What’s the difference — and can you have both?
If you are eligible for both Medicare and Medicaid, you may be eligible for an Aetna® Dual Eligible Special Needs Plan (D-SNP).
Aetna® is a recipient of the Newsweek America’s Best Customer Service Award for 2023.*
* FOR D-SNP MEMBERSHIP: Medicaid and CHIP Payment and Access Commission. Medicare Advantage dual eligible special needs plans. Accessed July 26, 2023. back
* FOR PARTS OF MEDICARE: Medicare.gov. Parts of Medicare. Accessed July 26, 2023. back
* FOR MEDICAID COVERAGE: Kaiser Family Foundation. 10 Things to Know About Medicaid. June 30, 2023. Accessed July 26, 2023. back
* FOR D-SNP ENROLLMENT PERIODS: Medicare.gov. Special Enrollment Periods. Accessed July 26, 2023. back
*FOR NEWSWEEK AWARD: The 2023 Newsweek America’s Best Customer Service rankings were identified from the results of an independent survey of more than 30,000 U.S. customers who have either made purchases, used services, or gathered information about products or services in the past three years. Customers evaluated several brands: In total, over 200,000 evaluations were collected. The awarded brands each received on average 100 evaluations from customers. For more information, visit https://www.newsweek.com/rankings/americas-best-customer-service-2023
Aetna Medicare is an HMO, PPO plan with a Medicare contract. Our DSNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. The formulary and/or pharmacy network may change at any time. You will receive notice when necessary. 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. 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. If your plan’s Extra Benefits Card includes roll-over, any unused amount will rollover into the next month/quarter. The monthly/quarterly amount can be rolled over through the end of the plan year but will not carry over into the next plan year.
Plan features and availability may vary by service area. For accommodation of persons with special needs at meetings, call 1-833-278-3924 (TTY: 711).
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. Member name(s) and other details have been omitted or fictionalized to protect the member’s (members’) identity(ies). For more information about Aetna plans, refer to our website.
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