New Jersey Dual Complete® Special Needs Plans (2024)

FAQs

What are distinct advantages of a dual special needs plan? ›

Examples of extra benefits a Dual Special Needs Plan may provide include: Credits to buy health products. Transportation assistance. Care coordination via a personal care coordinator.

In 2023, 5.2 million dual-eligible individuals were enrolled in a Medicare Advantage plan designed specifically for dual-eligible individuals, known as Dual-Eligible Special Needs Plans (D-SNPs).

Dual Special Needs Plans (D-SNPs) are Medicare Advantage (MA) plans that provide specialized care to beneficiaries dually eligible for Medicare and Medi-Cal, and offer care coordination and wrap-around services.

UHC Dual Complete Special Needs Plans (SNP) offer benefits for people with both Medicare and Medicaid. These SNP plans provide benefits beyond Original Medicare, such as transportation to medical appointments and routine vision exams.

FIDE SNP is fully integrated dual eligible special needs plan. MMP is Medicare-Medicaid plan. FFS is fee-for-service.

Dual eligible SNPs (D–SNPs), for beneficiaries dually eligible for Medicare and Medicaid benefits, had margins of 10.7 percent. …. The 2020 profit margin among nonprofit D–SNPs was 6.4 percent.” “All categories of SNPs had positive margins in 2019.

Like a D-SNP, a Chronic Condition Special Needs Plan (C-SNP) is a type of SNP. While D-SNPs are for people with both Medicare and Medicaid eligibility, C-SNPs are designed for people who have a specific chronic or disabling condition (e.g., diabetes or heart disease).

Medicare Dual Advantage (HMO SNP) is a Medicare Advantage plan for people who qualify for both Medicaid and Medicare. This plan helps coordinate your healthcare needs with no monthly premiums or deductibles.

A SNP may be any type of MA CCP, including either a local or regional preferred provider organization (i.e., LPPO or RPPO) plan, a health maintenance organization (HMO) plan, or an HMO Point-of-Service (HMO-POS) plan. There are three different types of SNPs: Chronic Condition SNP (C-SNP) Dual Eligible SNP (D-SNP)

What are the enrollment periods for DSNP? ›

The Initial Enrollment Period (IEP)is a seven month period which begins three months prior to the month containing your 65th birthday. It includes the entire month of your birthday and continues for three months after that month.

The roughly 12.5 million Americans with “dual eligibility” are among the most high-need patients served by the health care system, qualifying for Medicare due to age or disability and qualifying for Medicaid based on income. They make up 17% of the Medicare population but account for 33% of Medicare spending.

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan's contract renewal with Medicare.

If you have two jobs that both provide dental benefits or if you are covered by a second dental plan in addition to your own, you have what is called dual coverage. Dual coverage doesn't mean that your benefits are doubled. What it does mean is that you will likely enjoy lower out-of-pocket costs for your dental care.

On January 1, 2024, our plan name will change from UnitedHealthcare Dual Complete® (PPO D- SNP) to UHC Dual Complete ME-S001 (PPO D-SNP). We will mail you a new UnitedHealthcare member ID card.

What are Dual Special Needs Plans (D-SNP)? Medicare Advantage Plans uniquely designed for consumers enrolled in both Medicare and Medicaid.

A DSNP plan will include coverage for hospital services (Medicare Part A), medical health care needs (Medicare Part B), and prescription drugs (Medicare Part D) through a single plan. With a DSNP there may also be social services available to help coordinate a beneficiaries Medicare and Medicaid benefits.

Which statement describes the primary characteristic of a consumer who may benefit from a DSNP? Is enrolled in their state Medicaid program, typically as a Full Dual, with their Medicare cost sharing paid by the state in which they reside.