When Can I Sign Up for a D-SNP?

Written by:

Kayla Missman

Reviewed by:

Amy Albert

5 min read

Key Takeaways

Dual Eligible Special Needs Plans (D-SNP or DSNP) are Medicare Advantage plans for those who are eligible for both Medicare and Medicaid. These plans integrate coverage to provide simplified care coordination and additional benefits like prescription drug, dental, and vision coverage.
You can enroll in a D-SNP during a Special Enrollment Period (SEP) triggered by gaining Medicaid eligibility, or during recurring periods.
Full-benefit dually eligible beneficiaries can now use a monthly SEP starting in 2025.
To enroll, you need Medicare Part A and B, meet your state’s Medicaid requirements, and provide your Medicare ID and Medicaid ID numbers. Annual Medicaid redetermination is required to maintain eligibility.

You can sign up for a Dual Eligible Special Needs Plan (D-SNP, or DSNP) when you become eligible for both Medicare and Medicaid. Gaining Medicaid eligibility initiates a Special Enrollment Period, which allows you to choose a D-SNP Medicare Advantage plan. This article explores the pros and cons of D-SNP plans, eligibility requirements, and how to enroll.

Why Enroll In a DSNP?

Medicare provides healthcare for people over 65 and people with disabilities. Medicaid, a joint state and federal program, helps cover healthcare expenses for those with limited resources.

Medicaid benefits can bolster Medicare, delivering extra support for premiums, cost-sharing, and prescription drugs. In addition, Medicaid sometimes pays for services that Medicare does not cover, like dental and vision care, transportation, and over-the-counter services, helping those with limited income access important health services.

However, dually eligible people may need help navigating both programs and maximizing their benefits. For example, beneficiaries may encounter confusing appeals processes or redundant coverage requirements.

D-SNP plans, sold by private insurance companies, attempt to alleviate these obstacles by combining Medicare and Medicaid benefits. These plans have increased in popularity over the past decade: 29% of dually eligible individuals were enrolled in a D-SNP plan in 2021, nearly tripling the rate since 2010.

If you’re eligible for both programs, you can compare your options, shop around, and enroll during an enrollment period.

Ready for a new Medicare Advantage plan?

Should You Switch to a D-SNP Medicare Advantage Plan?

You are not obligated to enroll in a D-SNP plan if you are dually eligible. You can still choose Original Medicare or a non-integrated Medicare Advantage plan. Like any health insurance plan, D-SNP plans have pros and cons.

D-SNP Benefits

Integrated coverage: This is the primary benefit of a D-SNP plan. Instead of navigating two separate programs, you may only have to understand one plan’s rules. It can also simplify the appeals process, since you don’t have to figure out whether to contact Medicare or Medicaid.
Model of Care: D-SNP plans create a Model of Care for each enrollee. This framework explains how the plan will meet your individual needs. For example, you might work with an interdisciplinary care team, and the plan may assign a care coordinator or case manager to simplify communication between healthcare providers.
Beneficiary satisfaction: Dually eligible enrollees report higher satisfaction and better access to care in D-SNP plans than Original Medicare, a 2022 study found. However, the differences are less noticeable between D-SNP plans and other Medicare Advantage options.

D-SNP Drawbacks

Varying levels of plans: Not all D-SNP plans are equal. Insurance companies offer three levels of D-SNP plans, and a majority are “coordination only.” About 30% of available D-SNP plans are “highly integrated,” while only 10% are “fully integrated.” Plans with minimal coordination might not deliver as much practical help.
Research needed: Finding the right plan and enrolling may be confusing. On average, dually eligible people have 10 D-SNP plans to choose from, plus standard Medicare Advantage plans. With so many options, it can be challenging to understand which plans offer the most helpful benefits.

When Can You Sign Up for a D-SNP?

You qualify for a Special Enrollment Period (SEP) when you become eligible for both Medicare and Medicaid. You may also qualify for an SEP if you move or lose other healthcare coverage. SEPs typically last for two or three months, and your coverage starts the month after you enroll in a plan.

D-SNPs also have monthly SEPs throughout the year. In 2025, there is a monthly SEP for all full-benefit dually eligible beneficiaries to enroll in or change their DSNP plan, so long as it is not a “coordination only” DSNP. However, those who are partial-benefit dually eligible must now wait for one of the other recurring enrollment periods to enroll in a DSNP. This new monthly SEP replaces the quarterly SEP that existed in prior years.

Other D-SNP Enrollment Periods

Initial Enrollment Period: You can sign up for a D-SNP plan when you first become eligible for Medicare. If you qualify based on age, this period lasts for 7 months surrounding your 65th birthday. If you qualify for another reason, you have 3 months to enroll.
Annual Enrollment Period: Anyone with Medicare can change their insurance plan during this period, which lasts from October 15 to December 7. You can switch into a D-SNP plan if you’re eligible. Any changes go into effect on January 1.
Medicare Advantage Open Enrollment Period: Anyone with a Medicare Advantage plan may change their plan during this period, which lasts from January 1 to March 31. You can switch into a D-SNP plan if you’re eligible. Changes go into effect on the first of the month after you enroll.

How to Enroll in a D-SNP Medicare Advantage Plan

Since Medicare and Medicaid are separate programs, you must meet eligibility requirements for both. For Medicare, you must either be at least 65, have a disability, or have end-stage renal disease (ESRD). Medicaid eligibility varies by state.

D-SNP Eligibility

You have Medicare Part A and Part B
D-SNPs are available in your area
You meet your state’s requirements for Medicaid

Your plan will automatically renew each year as long as you’re eligible. However, you need to reverify your Medicaid eligibility annually.

What You Need to Know About D-SNP Redetermination

The process of reverifying your eligibility for Medicaid is sometimes called “recertification” or “redetermination.” Each year, your state will review whether you still qualify for Medicaid. You’ll receive a letter about your coverage. You must complete a renewal form if your state needs information to determine your eligibility.

D-SNP Documentation Needed

To enroll in a D-SNP, you’ll need your Medicare ID number and Medicaid ID number. It’s also helpful to have information about your current insurance plan, your preferred providers, and a list of services or prescription drugs you want covered.

Comparing Your D-SNP Options

Before enrolling, make sure you consider all D-SNP benefits and drawbacks.

Overall cost: Many D-SNP plans offer premium-free coverage. Research whether the plan pays for your Medicare premiums and out-of-pocket expectations.
Plan networks: D-SNP Medicare Advantage plans can limit your coverage to in-network providers. Ask the plan whether your preferred doctors are in its network.
Extra coverage: Many Medicare Advantage plans include prescription drug, vision, and dental coverage.
Coordination level: Read the plan’s benefits closely to ensure you understand the level of coordination the plan will provide between Medicare and Medicaid.

After choosing a plan, you can fill out an enrollment application online, either on your own or with the help of a licensed insurance agent or broker. You may need your Medicare ID and Medicaid ID. Your coverage will start the following month. If you change your mind, you can switch your coverage during another D-SNP enrollment period.

Putting It All Together

If you’re eligible for Medicare and Medicaid, a D-SNP plan can help coordinate your benefits. It may simplify your coverage and appeals process. However, insurance companies offer three levels of D-SNP plans, with some providing minimal coordination. If you need help choosing the right plan or understanding D-SNP eligibility and benefits, a licensed insurance agent or broker can help clarify the process.