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Dual Eligible Special Needs Plans (D-SNPs) From Anthem

If you have both Medicare and Medicaid you can enroll in an Anthem Dual Special Needs Plan, or D-SNP. It's a Medicare Advantage (Part C) plan that supports your whole health, all in one simple plan at little to no cost to you.

 

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Am I Eligible For A D-SNP?

Medicare Advantage Dual Special Needs Plans are for people eligible for both Medicare and Medicaid. These plans offer coordinated care and additional coverage not available with Original Medicare‡ . A D-SNP from Anthem can make life easier and help you stretch your budget.

Count On Valuable Benefits With An Anthem D-SNP

 

With an Anthem D-SNP, you'll keep your Medicaid coverage and get additional Medicare Advantage benefits that really add up. Depending on your eligibility, Anthem offers full and partial D-SNPs based on your Medicaid status.*

Benefits Prepaid Card

Over-the-counter health items, groceries1, 2, and utilities1, 2

$0   Premiums

Most plans have $0 monthly premiums which is good news for your pocketbook

$0  Copays

$0 prescription drug copays means your money goes further

Dental & Vision Benefits

Routine exams, cleanings, and a yearly eyewear allowance

Hearing Benefits

Routine hearing exams and hearing aids

Transportation

Rides2, 3 included to plan-covered services

Fitness Program

Stay in shape with free access to SilverSneakers® gym membership

Dedicated Support Team

Helps you understand your benefits and get the most out of your plan

Large Network

Large network of doctors and hospitals

* Benefits vary by state and plan

Flex Card: Great Benefits On One Card

image of an Anthem Benefits Prepaid Card

With a D-SNP, you can get an Anthem Benefits Prepaid Card with a monthly or quarterly allowance that you can use to pay for everyday items and expenses, such as:

 

 Over-the-counter (OTC) health items

 

 Groceries1, 2

 

 Assistive devices

 

 Utilities1, 2

 

 Dental, vision, or hearing out-of-pocket costs

 

Your card is preloaded, so it's ready to use just like a prepaid credit or debit card. Availability, benefits, and amounts may vary based on your state.

Smart Tip: Check to see if your doctors are in our network, and your prescriptions are covered with our easy-to-use tool.

When Can I Enroll In A D-SNP?

If you have Medicare Part A and Part B, you can enroll in a Dual Special Needs Plan the month you become eligible for Medicaid.

 

If you are already enrolled in a D-SNP plan, you may be able to change plans monthly depending on your current plan and/or the plan you want to enroll in. And if you've had a life event such as moving, losing coverage or newly eligible for Medicare, you may qualify for a Special Enrollment Period. You can always change plans during the Annual Enrollment Period from October 15 to December 7 every year.

 

 

Shop Dual Special Needs Plans   

Smart Tip: If you're not eligible for a D-SNP, Anthem offers other Special Needs Plans (SNPs) and Medicare Advantage plans that might be right for you.

Frequently Asked Questions About D-SNPs

Dual eligible means that you qualify both for Original Medicare as well as Medicaid. The state you live in decides who qualifies for Medicaid, and what types of Medicaid benefits you can receive.

Original Medicare is coverage managed by the federal government for people 65 or older, younger people with certain disabilities, and people with End-Stage Renal disease. Medicaid is a state program that provides medical and/or supplementary benefits based on your income level.

Most D-SNPs come with $0 premiums, copays, and deductibles. The amount you pay for a premium or out-of-pocket costs depends on whether you are fully or partially eligible. If you receive full Medicaid benefits, nearly all of your out-of-pocket costs should be covered by your state.

Full dual eligible means you receive full Medicaid benefits from your state’s program. Your Medicare Part A and B premiums and nearly all of your out-of-pocket costs may be paid based on your state’s program.

 

Partial dual eligible means you qualify for Medicaid but based on your income, you don’t receive full medical benefits. Depending on your state, you may have to pay some out-of-pocket costs for premiums and medical care.

No, not at all. A D-SNP lets you keep all your Medicaid benefits and coordinates them with your Medicare coverage. That way you can access all your benefits more easily. With an Anthem D-SNP, you'll get valuable benefits and the support you need.

 

But it's important to keep in mind that you need to renew your Medicaid coverage every year to stay enrolled in a D-SNP. Medicaid benefits are reviewed by the state agency to make sure you're still eligible. You will get a notification from your state agency when it's time to complete your renewal. Make sure to return it right away because if your Medicaid coverage isn't renewed, you may lose eligibility for a D-SNP as you need both Medicaid and Medicare. Call us if you have any questions about your eligibility or plan options.

Read Our Medicare Articles

 

Compare the differences between Medicare and Medicaid plans. You can also take a deeper dive and learn about Medicare Advantage enrollment, benefits, and more.

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 Original Medicare: Part A (Hospital Insurance) and Part B (Medical Insurance).

 

1 Members may receive a monthly or quarterly allowance in the form of a benefits prepaid card to pay for a wide range of approved groceries and utilities. Unused amounts will expire at the end of the month or quarter. Benefits vary by plan.

 

2 Depending on your plan, the benefits listed may be available through the Medicare Advantage Value-Based Insurance Design Model or to eligible members as Special Supplemental Benefits for the Chronically Ill (SSBCI). You may qualify for SSBCI if you have a high risk for hospitalization and require intensive care coordination to manage chronic conditions such as Chronic Kidney Diseases, Chronic Lung Disorders, Cardiovascular Disorders, Chronic Heart Failure, or Diabetes. For a full list of chronic conditions or to learn more about other eligibility requirements needed to qualify for SSBCI benefits, please refer to Chapter 4 in the plan's Evidence of Coverage.

 

3 Transportation services are issued as one-way trips and provided on an annual basis. Benefits vary by plan.

 

The Benefits Mastercard® Prepaid Card is issued by The Bancorp Bank, N.A., Member FDIC, pursuant to license by Mastercard International Incorporated. Mastercard is a registered trademark, and the circles design is a trademark of Mastercard International Incorporated. This is a benefits card that can only be used at certain Mastercard merchants participating in this program and will be authorized for qualified purchases as set forth in your Terms and Conditions. Valid only in the U.S. No cash access. Other languages are available upon request.

Anthem Blue Cross and Blue Shield, a Medicare Advantage Organization with a Medicare Contract in Colorado, Connecticut, Georgia, Indiana, Kentucky, Missouri, New Hampshire, Nevada, New York, Ohio and Wisconsin, offer HMO, HMO D-SNP, HMO C-SNP, HMO I-SNP, LPPO, LPPO D-SNP and/or RPPO. Anthem Blue Cross and Blue Shield offers PDP plans in Colorado, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin. Anthem Blue Cross and Blue Shield HMO D-SNP and LPPO D-SNP plans contract with state Medicaid programs. Anthem Blue Cross and Blue Shield Retiree Solutions, a Medicare Organization with a Medicare Contract in New York, offers LPPO plans. Enrollment in Anthem Blue Cross and Blue Shield and Anthem Blue Cross and Blue Shield Retiree Solutions plans depend on contract renewal.