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New Jersey residents who have both Medicare and Medicaid, known as "dual eligibles," can enroll in a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP).  A FIDE SNP is a special kind of Medicare managed care plan that coordinates all covered Medicare and Medicaid benefits in one health plan.

If you or a trusted family member or doctor heard about FIDE SNP health plans and would like to know more about them, please use this web page as a guide to get started.

FIDE SNP 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 benefits
  • All the same member rights available to Medicare and Medicaid recipients
  • Extra benefits not available under other Medicare or Medicaid plans

 Coverage

Most FIDE 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 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.

In all of these cases, though, the FIDE SNP covers the service directly, so there is no need to worry about whether the service is typically covered by Medicare or Medicaid.  For members, the service is simply covered by the FIDE SNP plan.  Members have a single plan, a single ID card, and a single, comprehensive network of providers to meet their needs.

Frequently Asked Questions (FAQ):

What is a FIDE SNP?

A Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP) is a special kind of Medicare managed care plan that coordinates all covered Medicare and Medicaid benefits in one health plan. This plan coordinates delivery of covered Medicare and Medicaid health and long-term care services in a combined effort to organize and collaborate on a member’s health needs to deliver the best possible care.

Who is eligible?

  1. Have Medicare Parts A and B;
  2. Have full NJ Medicaid benefits;
  3. Not be simultaneously enrolled in Programs of All-Inclusive Care for Elderly (PACE)
  4. Be a full time New Jersey resident;

How do I enroll in a FIDE SNP?

To enroll in a FIDE SNP plan, contact Medicare by calling 1-800-MEDICARE (1-800-633-4227; TTY# 1-877-486-2048), 24 hours a day, 7 days a week.
You may also contact the FIDE SNP plan directly:

Aetna Assure Premier Plus: 1-844-362-0934 (TTY: 711)

Wellpoint Full Dual Advantage: 1-844-765-5160 (TTY: 711)

Wellcare Dual Liberty: 1-866-892-8340 (TTY: 711)

Horizon NJ TotalCare: 1-800-543-5656 (TTY: 711)

UHC Dual Complete NJ-Y001: 1-800-514-4911 (TTY: 711)

How do I use my benefits?

When you visit a doctor/provider or pharmacy, present your FIDE SNP member ID card. You should hold on to your original Medicare and Medicaid cards but you won’t need to use them.

I don’t want to be enrolled in a FIDE SNP plan anymore. How can I dis-enroll?

You may change your enrollment by disenrolling or switching plans once each quarter: January through March; April through June; July through September; and September through December. Enrollment changes follow the standard rules of the Medicare Annual Enrollment Period.

If you disenroll from your FIDE SNP plan, your Medicare coverage will return to Original (fee-for-service) Medicare Parts A and B, and you will automatically be assigned a benchmark (relatively low-cost) Part D prescription plan. Your Medicaid coverage will automatically change to the NJ FamilyCare plan associated with your FIDE SNP. Typically, your enrollment will change as of the first day of the next month.

To disenroll, call 1-800-MEDICARE (1-800-633-4227; TTY: 1-877-486-2048). At this time, you also have the option to choose a different type of Medicare plan, such as a Medicare Advantage plan, and/or a different Part D prescription plan. If you want to choose a different NJ FamilyCare (Medicaid) plan than the one associated with your FIDE SNP, you should call NJ FamilyCare at 1-800-701-0710 (TTY: 711).

Do you have additional questions or need further assistance?

Contact your NJ State Health Assistance Program (SHIP) at 1-800-792-8820, Monday – Friday, between 8:30 a.m – 4:30 p.m.

 
 
 
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