Dual eligible special needs plans (2024)

Looking for the federal government’s Medicaid website? Look here atMedicaid.gov.

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. This plan is available to anyone who has both Medical Assistance from the State and Medicare.Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Premium disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Benefit disclaimer

Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Nurse Hotlinedisclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time.Nurse Hotline not for use in emergencies, for informational purposes only.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® (Medicare-Medicaid plan)

UnitedHealthcare Connected® (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan) is a health plan that contracts withboth Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® general benefit disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the member handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® member handbook.

UnitedHealthcare Senior Care Options (HMO SNP) plan

UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system.The 5-Star rating applies to plan year 2024.

Important provider information

The choice is yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsem*nt of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate information

To report incorrect information, emailprovider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call1-888-638-6613/ TTY 711, or use your preferred relay service.

Declaration of disaster or emergency

If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.

Dual eligible special needs plans (2024)

FAQs

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

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.

What is SPD dual? ›

A Dual Special Needs plan, or D-SNP for short, is a type of health insurance plan. It's for people who have both Medicare and Medicaid. If that's you, you're "dual-eligible." (That's just another way of saying you can have Medicare and Medicaid at the same time.)

What are the three types of SNP plans? ›

There are three different types of SNPs:
  • Chronic Condition SNP (C-SNP)
  • Dual Eligible SNP (D-SNP)
  • Institutional SNP (I-SNP)
Sep 6, 2023

What is a dual eligible special needs plan quizlet? ›

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

What are key characteristics of DSNP plans? ›

Generally speaking, D-SNPs include the following:
  • Care coordination.
  • $0 monthly premiums.
  • Over-the-counter quarterly benefits.
  • Dental, vision, and hearing benefits.
  • Transportation benefits.
  • Gym memberships.
  • Telehealth services.

How many Americans are dual eligible? ›

Trends in Dually Eligible and Medicare-only Enrollment

o The number of dually eligible beneficiaries increased from 8.6 million in 2006 to 12.3 million in 2019, an AAGR of 2.8 percent.

What is the difference between DSNP and Fide SNP? ›

As of January 1, 2023, FIDE SNPs are D-SNPs that provide coverage of Medicare and Medicaid benefits under a single legal entity that holds both: (1) an MA contract with CMS; and (2) a contract with the state Medicaid agency that meets the requirements of a managed care organization as defined in section 1903(m) of the ...

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.

What does DSNP mean? ›

Key Takeaways. Roughly 12.5 million Americans have both Medicare and Medicaid coverage. These people are referred to as “dual eligible.” D-SNPs, or Dual Eligible Special Needs Plans (D-SNPs), offer standard Medicare benefits as well as additional coverages and services that meet the unique needs of its members.

Do all SNP plans have drug coverage? ›

All SNPs must provide Medicare drug coverage (Part D).

Can a SNP be a PPO? ›

Your Medicare SNP may be a Health Maintenance Organization (HMO) or a Preferred Provider Organization (PPO). Depending on your plan, you may need to see in-network providers to receive coverage, or have the option of going out of network.

What is an Aetna special needs plan (SNP)? ›

Aetna® Dual Eligible Special Needs Plans, or D-SNPs, provide extra support to help pay for everyday expenses like healthy groceries, utilities and even rent. That's on top of our medical coverage and $0 copay for covered Part D medicines at in-network pharmacies.

What are dual eligible SNPs? ›

Dual Eligible Special Needs Plans (D-SNPs) enroll individuals who are entitled to both Medicare (title XVIII) and medical assistance from a state plan under Medicaid (title XIX).

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

D-SNP benefits
  • Routine dental care. ...
  • A monthly credit to spend on healthy food, over-the-counter products and pay utility bills. ...
  • Routine eye exams, plus credit for eyewear.
  • Routine hearing exams, plus credit for hearing devices. ...
  • Rides to health care visits and the pharmacy. 3,5

What is dual needs? ›

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.

What is the benefit of SNP? ›

SNPs help predict an individual's response to certain drugs, susceptibility to environmental factors such as toxins, and risk of developing diseases. SNPs can also be used to track the inheritance of disease-associated genetic variants within families.

What is dual advantage? ›

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.

What best describes a DSNP plan? ›

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. All D-SNPs in California must have executed contracts with the Department of Health Care Services (DHCS), the state Medicaid agency.

What are the benefits of UnitedHealthcare Dual Complete? ›

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.

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