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New Jersey residents who have both Medicare and Medicaid, known as "dual eligibles," can enroll in a Dual Eligible Special Needs Plan (D-SNP, pronounced "dee-snip").  A D-SNP is a special kind of Medicare managed care plan that coordinates all covered Medicare and Medicaid managed care benefits in one health plan.

If you or a trusted family member or doctor heard about D-SNP health plans and would like to know more about them, please use this web page as a guide to get started. A free Guide about Special Needs Plans is available from Medicare, too. Click here to go to Medicare's SNP Guide.

Dual Special Needs Plan Features:

  • A team of doctors, specialists, and care managers working together for you
  • No co-payments, premiums or deductibles
  • One health plan to coordinate  all your Medicare and Medicaid managed care benefits
  • All the same member rights available to Medicare and Medicaid recipients
  • Extra Medicare benefits not available under other Medicare or Medicaid plans
  • D-SNPs may require referrals before you make an appointment to see specialists

 Coverage

Most D-SNP covered services are covered by Medicare, and a few are covered exclusively by Medicaid, including dental, vision, hearing aids and fittings, certain private duty nursing services, medical day care, personal care assistance, and 30 days of long-term nursing facility stays.

Generally, when Medicaid covers health care services beyond the limits of Medicare, then Medicaid will pay for what Medicare does not.

Information for Consumers

Click here for a NJ Medicaid consumer quick reference guide to learn more about:
  • Eligibility
  • Before you Enroll…Consumer Guide
  • Is the D-SNP you like available in your county?
  • Provider Directories
  • Formularies (Lists of Covered Prescription Drugs)
  • Supplemental Benefits
  • How to Enroll in a D-SNP
  • How to Transfer from one D-SNP to another
  • How to Disenroll from a D-SNP (and return to a regular Medicaid HMO)
  • What if I have a problem?

Click here for Frequently Asked Questions (FAQs) about changes to Dual Eligible Special Needs Plans for 2015

Frequently Asked Questions (FAQs) for Dual Eligible Special Needs Plans (D-SNP) and MLTSS Consumers

Information for Health Care Providers

Click here for a provider quick reference guide to learn more about:
  • NJ Medicaid Managed Care Provider Relations
  • Links to each D-SNP’s Provider pages
  • Links to each D-SNP’s Provider Manuals
Click here for Frequently Asked Questions (FAQs) about changes to Dual Eligible Special Needs Plans for 2015

Frequently Asked Questions (FAQs) for Dual Eligible Special Needs Plans (D-SNP) and MLTSS Consumers

 
 
 
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