Dual Eligible Special Needs Plans
Improving D-SNPs in Wisconsin
The Department of Health Services (DHS) is working to improve the experience members have with both Medicare and Medicaid coverage in Wisconsin. See what we’re doing and how you can get involved on the Improving Access to Medicare and Medicaid Coverage webpage.
A Dual Eligible Special Needs Plan, also called a D-SNP, is a kind of Medicare Advantage plan for people who have both Medicare and Medicaid.
D-SNPs cover hospital, medical, and prescription costs—all in one plan, with little or no costs. The plans have provider networks. You may need to see doctors who are in your plan's network to have your bills covered.
D-SNPs work best when you’re enrolled in the same company’s HMO (health maintenance organization) for Medicaid. That way, the same company provides both your Medicare and Medicaid coverage.
Medicare and Medicaid usually don't coordinate. Separate companies provide managed care for each plan.
Medicare and Medicaid benefits are coordinated. When you have a Medicare D-SNP and Medicaid HMO or managed care organization (MCO) through the same company.
Is a D-SNP plan right for me?
To find out:
- Read the FAQs (frequently asked questions) to learn more about D-SNPs.
- Read our brochure, Medicare and Medicaid brochure, P-03556 (PDF) to learn more about D-SNPs.
- Check which D-SNPs are available in your county and which Medicaid plans they accept. (Excel)
- Check Medicare.gov to see if your prescription drugs are covered by the plan.
- Call the plan or search their website to see if your doctors are in-network.
- Get free and unbiased help with Medicare from the State Health Insurance Assistance Program.
Default enrollment notices
If you’re enrolled with an SSI Medicaid HMO and getting Medicare for the first time, you may be enrolled with a Medicare D-SNP offered by the same HMO you currently have for your SSI Medicaid. This is called “default enrollment.”
These are examples of default enrollment notices sent by D-SNP organizations:
- D-SNP Default Enrollment Notice Language and Opt-Out Form (PDF)
- D-SNP Default Enrollment Notice Template Language for Family Care Partnership (PDF)
The following companies conduct default enrollment:
- Elevance Health (Anthem): Anthem MediBlue Dual Advantage (HMO D-SNP) (H9525-003)
- iCare: iCare Medicare Plan (HMO D-SNP) (H2237–001)
- Managed Health Services (WellCare): WellCare Dual Access (HMO D-SNP) (H8189-001)
- Molina: Molina Medicare Complete Care (HMO D-SNP) (H2879-001)
- UnitedHealth Care: UnitedHealthcare Dual Complete LP1 (HMO-POS D-SNP) (H3794-002)
See which D-SNPs are available in your county
Use the D-SNP spreadsheet (Excel) to filter for plans.
For some plans, costs depend on what type of Medicaid you have. People with full Medicaid and/or the Qualified Medicare Beneficiary (QMB) Medicare Savings Program have lower costs than people with other types of Medicaid. Learn more in the Medicare Savings Programs publication, P-10062.
This information supplements what's on the Medicare.gov Plan Finder.
Resources for professionals
Professionals can access D-SNP resources on the GWAAR Medicare Outreach and Assistance Resources webpage under Dual Special Needs Plans (D-SNPs).