Get More With Medicare vs. Medicaid & Dual Eligibility, D-SNP Plans

How To Get More Benefits with Dual Medicaid-Medicare, D-SNP Plans

Support for North Carolina residents who have Medicare and Medicaid

Dual Special Needs Plans (D-SNPs) are specialized Medicare Advantage plans for people with Medicare and Medicaid. They typically offer many extra benefits and features beyond Original Medicare. If you’re a North Carolina resident, our team of local Medicare agents in NC can help you understand how to get more benefits with these dual plans.

If you’re looking for information on Medicare plans in NC, it’s essential to understand that these plans are designed to help people with the highest needs to cover any out-of-pocket costs that they would typically be responsible for paying under traditional Medicare. Follow these steps to learn how you can access more benefits with a dual plan:

Find out if you’re eligible

If you are over 65 years old, have certain health conditions or disabilities, and have limited income to help you pay for your health care, you may qualify for both state and federal health insurance programs. People eligible for both are known as dual eligibles, and this group makes up about 20% of all Medicare beneficiaries (equivalent to approximately 12 million Americans). 

If you’re eligible for both Medicare and North Carolina’s Medicaid program, you may qualify for no-cost or low-cost healthcare under a D-SNP. To be considered, you must be first enrolled in Original Medicare (parts A and B). Other eligibility requirements include:

  • You live in the geographic service area of your chosen plan
  • You are a US citizen or are lawfully present in the US
  • You’re eligible for one of the following Medicaid Savings Programs:
    • Qualified Medicare Beneficiary
    • Specified Low-Income Medicare Beneficiary Plus
    • Full Benefit Dual-Eligible

Learn about how it works

D-SNPs are a Medicare Advantage plan. With most Medicare Advantage plans, you’re responsible for covering a portion of your plan costs out of your own pocket. These costs may relate to hospitalization, prescriptions, or outpatient medical care. However, with a D-SNP plan, all or most costs are covered by Medicare and Medicaid.

Federal law sets the income standards relating to Medicaid. Still, each state also has its own Medicaid eligibility and coverage limits, so it’s a good idea to get advice from someone in your local area who understands how D-SNPs work in North Carolina. 

Discover what makes Dual Special Needs Plans different

Medicaid is a joint federal and state government program. Dual Eligible Plans also include help to coordinate care. These plans typically include additional benefits like:

  • Dental Coverage
  • Prescription Drug Coverage
  • Health Product and Over-the-Counter item Credits
  • Food Allowance
  • Vision Coverage
  • Transportation Services
  • Fitness Programs

Talk to a local Medicare agent to find out if a Dual Special Needs Plan is right for you

The easiest and fastest way to find out about Medicare plans in North Carolina is to chat with someone who can assess your eligibility and determine if it’s right for you. Our Medicare agents Charlotte, and other areas across the state are passionate about helping people living in North Carolina to get the best health coverage for their needs.

A dual plan may be right for you if:

  • You have full Medicaid Benefits and Medicare
  • You have complex medical needs
  • You need help coordinating care
  • You’d like extra benefits.

To learn more about the difference between Medicare and Medicaid, or any other health insurance options in NC, get in touch with our North Carolina Medicaid office today:

  • Call: 888-245-0179 8:00am– 5:00pm Monday through Friday
  • NC Medicaid website 
Compare Plans Now 1-800-797-0327

*Article Updated 2022