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Ask an Expert

Bob O’Connor and Denise King on DSNP

Q: What is a DSNP?
A: A DSNP (dual special needs plan) is a special type of Medicare Advantage Prescription Drug Plan (MA-PD) that provides benefits to members who qualify for Medicare and are receiving full Medicaid benefits and/or assistance with Medicare premiums or Medicare Parts A & B cost sharing through one of the Medicare Savings Program (MSP) categories. Members must reside in a county where Aetna Medicare offers a DSNP.

Q: Are there any requirements for a DSNP?
A: Unlike PACE and PACENET, a DSNP is not only for seniors. You have to qualify for both Medicare (65 and older or under 65 with certain disabilities) and Medicaid (receive assistance with Med-icare premiums or eligible for full Medicaid benefits and assistance with Medicare costs). So someone who is 40 years old and living with certain disabilities can qualify for a D-SNP. A DSNP will help you maximize your Medicare and Medicaid benefits.

Q: What services do D-SNP members receive?
A: Members enrolled in a D-SNP plan have an Interdisciplinary Care Team (ICT) that works to-gether to help each member receive the most appropriate, highest quality of care. Each mem-ber has an Individualized Care Plan (ICP) based on the results of their comprehensive Health Risk Assessment (HRA).

Q: What makes this a plan for people who are dual-eligible?
A: Dual special needs plans are for people who could use some extra help. That may be because of income, disabilities, age and/or health conditions. Dual plans are a type of Medicare Ad-vantage plan. Dual special needs plans are also called D-SNP for short. These names all mean the same thing.

Members enrolled in an Aetna Medicare DSNP plan may have Medicaid coverage through Aet-na Medicare, the state, or another plan. Aetna Medicare’s clinical teams will assist with coor-dination of care for any covered service provided to an Aetna Medicare DSNP member.

Q: Do you have any final takeaways for our readers?
A: If you are dual eligible and are on other programs, you will want to shop around since there have been improvements on many of the plans including coverage for additional benefits. It’s always good to examine what you are eligible for so you can maximize your coverage.

For more information, visit www.aetnamedicare.com and https://aetna.benefitscheckup.org/welcome-aetna/      

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