According to the Center for Medicare and Medicaid Services, approximately 150,000 people in Washington who are eligible for a Dual Special Needs health plan (DSNP, or dual plan) aren’t enrolled in one. That means dual-eligible consumers could have up to three different coverage entities providing their care – the U.S. government, the state and a managed care organization – which may make it more complicated to provide coordination of care.
The 2019 annual enrollment period has ended, but people who are dually eligible for Medicare and Medicaid can use a special election period to change plans once per quarter during the first nine months of the year.
About 9 million people in the U.S. are dual-plan-eligible.
The Center for Medicare and Medicaid Services (CMS) notes that dual plans enroll beneficiaries who are entitled to Medicare and medical assistance from a state plan under Medicaid, and offer the opportunity of enhanced benefits by combining those available through Medicare and Medicaid. Those who qualify for Medicare and Medicaid may be eligible to enroll in a dual plan that may offer additional benefits such as dental, hearing and vision coverage. Dual-eligible consumers may be in poorer health and require more care, or may need additional financial support. These additional benefits and services could play a larger role in keeping them healthier.
With a dual plan, recipients may also receive help to purchase approved health items, transportation to health care appointments, and to manage and coordinate their care. People eligible for a dual plan can often enroll for no monthly premium, which may help make it an affordable option.
Additional information is available from private health plan companies and cms.gov.
Source: United Healthcare of Washington