New Jersey residents who have both Medicare and Medicaid, known as "dual eligibles," can enroll in a Dual Eligible Special Needs Plan (D-SNP, pronounced "dee-snip"). A D-SNP is a special kind of Medicare managed care plan that coordinates all covered Medicare and Medicaid managed care benefits in one health plan.
If you or a trusted family member or doctor heard about D-SNP health plans and would like to know more about them, please use this web page as a guide to get started. A free Guide about Special Needs Plans is available from Medicare, too. Click here to go to Medicare's SNP Guide.
Dual Special Needs Plan Features:
- A team of doctors, specialists, and care managers working together for you
- No co-payments, premiums or deductibles
- One health plan to coordinate all your Medicare and Medicaid managed care benefits
- All the same member rights available to Medicare and Medicaid recipients
- Extra Medicare benefits not available under other Medicare or Medicaid plans
- D-SNPs may require referrals before you make an appointment to see specialists
Most D-SNP covered services are covered by Medicare, and a few are covered exclusively by Medicaid, including dental, vision, hearing aids and fittings, certain private duty nursing services, medical day care, personal care assistance, and 30 days of long-term nursing facility stays.
Generally, when Medicaid covers health care services beyond the limits of Medicare, then Medicaid will pay for what Medicare does not.
Information for Consumers|
Click here for a NJ Medicaid consumer quick reference guide to learn more about:
- Before you Enroll…Consumer Guide
- Is the D-SNP you like available in your county?
- Provider Directories
- Formularies (Lists of Covered Prescription Drugs)
- Supplemental Benefits
- How to Enroll in a D-SNP
- How to Transfer from one D-SNP to another
- How to Disenroll from a D-SNP (and return to a regular Medicaid HMO)
- What if I have a problem?
Click here for Frequently Asked Questions (FAQs) about changes to Dual Eligible Special Needs Plans for 2016
Frequently Asked Questions (FAQs) for Dual Eligible Special Needs Plans (D-SNP) and MLTSS Consumers