Dual Eligible Special Needs Plans (D-SNPs)

Dual Eligible Special Needs Plans are for people who are eligible for both Medicare Advantage and Medicaid. With a Humana Medicare Advantage D-SNP, we take into account your Medicare Advantage and state Medicaid benefits to help you get the most out of your coverage.

When you have more than one health plan, there are rules to decide which healthcare plan pays first, called the Coordination of Benefits. With our D-SNP, Humana is your primary payer. We pay what we owe on your bills first and send the remaining amount to your healthcare provider to submit to your state Medicaid plan—your secondary payer.

Like all Medicare Advantage plans, D-SNPs are required by law to provide all the benefits of Original Medicare Part A and Part B. But these plans are designed for members with special needs, so they also offer special benefits, including prescription drug coverage with every plan at no additional cost.

Humana’s D-SNPs may also include valuable added benefits like:

• A $0 monthly plan premium
• $0 Rx copays
• A Healthy Options Allowance to pay for approved items like healthy foods or even utility bills
• An over-the-counter (OTC) allowance for purchasing approved OTC drugs and health-related supplies
• Routine dental, vision and hearing care
• Meal delivery services after an inpatient hospital stay
• A care coordinator to help you manage your care
• Care coordination
• Disease management
• Transportation benefits
• SilverSneakers^® gym membership
• Telehealth options

Plan availability varies by state and service area.

Some costs related to D-SNPs may include:

• Medicare Part B premium: Most Medicare members must continue to pay the monthly Medicare Part B medical premium. In 2023, the Part B premium is $164.90.
• D-SNP plan premium: Monthly plan premiums vary based on plan choice and location and may be as low as $0.

Cost-sharing expenses, such as:

• Deductibles are the set amount you pay for care before your plan kicks in.
• Copays are a set dollar amount you pay for prescriptions or healthcare provider visits at the time of service.
• Coinsurance is a percentage of costs you pay after you've met your deductible.

If you’re turning 65 and newly eligible for Medicare, you can join any Medicare SNP you qualify for during your Initial Enrollment Period. That starts 3 months before you turn 65, includes the month you turn 65 and ends 3 months after you turn 65.

You can also join any Medicare SNP you qualify for during the Medicare Annual Enrollment Period (AEP) between Oct. 15 – Dec. 7, with coverage beginning Jan. 1.