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Dual Eligible Special Needs Plan (D-SNP)

A Dual Eligible Special Needs Plan (D-SNP) is a type of health planA group of doctors, specialists, clinics, pharmacies, hospitals, and long-term care providers that work together to meet your needs.
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that includes all your MedicareThe federal health program that provides health care benefits for people age 65 years or older, people age 65 years or younger with certain disabilities, and people with certain diseases.
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and some Medi-CalCalifornia’s Medicaid program. Medi-Cal offers health coverage for low-income Californians.
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benefitsMedicare and Medi-Cal cover health care benefits, which are medically-necessary services that you get from your health plan and/or individual providers.
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, as well as some extra benefitsHealth care services provided by your health plan or program that have no extra cost to you.
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.

  • You don’t lose any Medi-Cal benefits, you still get those benefits from Medi-Cal like you do today. This includes long-term services and supportsA variety of services aimed at helping people with daily living activities.
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    like In-Home Supportive Services (IHSS)The IHSS program provides in-home care for people who cannot safely remain in their own homes without assistance.
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    or adult day centersCenters that provide daytime health care, such as nursing, therapies, social activities, and meals for people who don’t need care 24/7.
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  • You might get a helper (like a nurse or Care Manager) to be your main point of contact and make sure you get all the care you want and need, including equipment and supplies.
  • Your D-SNP health plan will help you find new providers if your providersA person or organization that provides health care-related services, like a doctor, hospital, or clinic.
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    are not in your health plan’s network.
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Benefits 

Benefits

  • Includes ALL your Medicare benefits, including doctors, hospitals, prescription drugs, lab tests and X-rays, and some medical equipmentThis is equipment ordered or prescribed by your doctor to use at home.
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  • Helps you with your Medi-Cal benefits:
    • Includes SOME of your Medi-Cal benefits, including medical suppliesSupplies that are typically disposable, single use, medically-related, and often ordered or prescribed by a physician.
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      and equipment and transportationMedicare covers emergency ambulance services. Medi-Cal provides transportation to non-emergency, medically-necessary services, like doctor visits or to pick up a prescription.
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    • Will help you get the rest of your Medi-Cal benefits, including long-term services and supports like IHSS and adult day centers. These benefits still stay separate from your D-SNP health plan. You don’t lose any of your Medi-Cal benefits.
  • You might get extra benefits like:
    • Extra dental, hearing, and vision coverage.
    • Extra help so you can live in your home and community safely, like shower grab bars and ramps.
    • Gym membership.
  • You may get a Care Coordinator. This is someone, like a nurse or other helper, whose job is to be your main point of contact and help you get all the health care services you want and need.

Considerations

  • D-SNP health plans have networks of providers, like doctors, hospitals, clinics, labs, and equipment suppliers. The health plan will ask you to use the providers in their networkA group of doctors, hospitals, pharmacies, and other health care professionals that work with your health plan to provide all your health care services.
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    , because that is how they can help you best.
    • If your doctor or hospital is not already in the health plan’s network, they might have to join the network, or you may have to switch. You may also have to switch where you get your medical supplies and equipment.
    • Your D-SNP health plan can help you find new doctors and service providers that meet all your needs.
  • D-SNP health plans won’t cover all your Medi-Cal benefits, but can help arrange for you to get your Medi-Cal benefits. You don’t lose any of your Medi-Cal benefits.
    • Your Medi-Cal long-term services and supports stay separate, like IHSS, adult day centers, and the nursing home where you reside (if applicable). You keep these services and providers the way they are now.
  • Please note that you cannot enroll in a D-SNP online and some plans require you to call them to enroll and/or to get more information about their specific D-SNP plan.

To qualify for D-SNP, you must:

  • Have Medicare and Medi-Cal.
  • Live in a ZIP code where a D-SNP health plan is available.
Success Stories 
Next Steps 

Ready to take the next step?

Download Helpful Tools

Use these tools to understand your next steps and organize your health information:

Download Next Steps Checklist

Download Health Profile Worksheet

Contact Help Services

Visit our Get Help page for links and phone numbers to people who can help you understand your Medicare and Medi-Cal benefits and assist you in choosing a care option.

Explore More About D-SNP

Medicare.gov

CMS Dual Eligible Special Needs Plans

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