What is a D-SNP, or Dual Eligible Special Needs Plan?
A Dual Eligible Special Needs Plan offers affordable Medicare Advantage benefits to Medicaid members — learn more here
No one should have to choose between having affordable health insurance and putting healthy food on the table. Unfortunately, it’s a common struggle for many Americans. If you’re one of them, you may be able to get help from a Dual Eligible Special Needs Plan, or D-SNP.
A Dual Eligible Special Needs Plan is a type of health insurance plan designed for individuals who are eligible for both Medicare and Medicaid. People who qualify are “dual eligible.” They tend to have greater health care needs than others.
That's why D-SNPs offer additional coverage than other Medicare plans. For example, Aetna® offers plans that include dental, vision and hearing coverage. Aetna members also get a monthly allowance to pay for certain over-the-counter (OTC) health and wellness products. And all Aetna D-SNP members get prescription drug coverage. The overall goal: to deliver quality and efficient care at a low or no cost.
About D-SNP medical and drug coverage
D-SNPs offer affordable Medicare Advantage benefits for members with Medicaid.
Medicare is a federal health insurance program that primarily covers individuals age 65 and older, as well as some younger individuals with disabilities. A Medicare Advantage plan includes two parts:*
1. Medicare Part A and B (hospital insurance and medical insurance).
Part A covers:
- Inpatient care in hospitals
- Skilled nursing facility care
- Hospice care
- Home health care
Part B covers:
- Services from doctors and other health care providers
- Outpatient care
- Home health care
- Durable medical equipment, for example, wheelchairs, walkers and hospital beds
- Preventive services, for example, screenings, shots, vaccines and yearly “wellness” visits
Get the support of a personal care team
Aetna® care teams are here to help manage your care and connect you with the health and community services you may need.
2. Medicare Part D (Drug coverage). Part D covers the cost of prescription drugs at in-network pharmacies, as well as certain shots or vaccines.
Medicaid is a joint federal and state program. It provides health coverage to people with low incomes, disabilities or certain illnesses. With a D-SNP, Medicaid provides coverage to help pay for premiums, cost sharing and services not covered by Medicare.*
More information about plans
All plans are different, but they all offer additional coverage and benefits you wouldn’t normally get with a health plan. Aetna plans come with:
A dedicated care team. D-SNP members get access to a care team that offers support to help manage care and connect members with the health and community services they may need.
Dental, vision and hearing coverage. Aetna Dual Eligible Special Needs Plans include coverage for dental, vision and hearing.
$0 copay. Members have no copay on covered Tier 1 prescription drugs at in-network pharmacies.
Extra Benefits Card. Aetna D-SNP members get an Extra Benefits Card with a monthly allowance to pay for certain over-the-counter (OTC) products. Members with a qualifying chronic condition who meet all other criteria can use the monthly allowance to help pay for additional expenses including certain healthy foods and more.
Who’s eligible?
To qualify, you must be eligible for both Medicare and Medicaid. If you’re worried that switching to a D-SNP may cause you to lose your Medicaid coverage, rest easy: It won’t.
One of the easiest ways to find out if you qualify for a D-SNP? Talk to a licensed agent. A licensed Aetna agent can confirm your eligibility. And they can answer your questions for free.
How to enroll
If you're eligible, here’s how to apply for dual Medicare and Medicaid. The first step is to compare plans in your area based on cost, coverage and benefits, to find the right one for you. A licensed agent can be super helpful with this, too.
Another good idea is to check out the website of the health plan you're interested in. For example, Aetna has a free online tool that makes it easy to search for plans in your area. All you need is your ZIP code to get started.
Timing is also important. There are four times when you can enroll.
Initial Enrollment Period (IEP): This enrollment period is only available when you first become eligible for Medicare. Your IEP is the seven-month period that begins three months before your 65th birthday, includes your birthday month and ends three months afterward. There is an exception if your birthday falls on the first of any month: Your seven-month IEP begins and ends one month sooner.
Annual Enrollment Period: The Annual Enrollment Period for health insurance plans runs every year from October 15 to December 7. During this time, you can pick a new plan (or any Medicare Advantage plan), switch from Original Medicare to Medicare Advantage or change your Part D coverage.
Open Enrollment Period (OEP): This occurs annually from January 1 to March 31. It allows beneficiaries who are already enrolled in a Medicare Advantage plan to make certain changes to their coverage.
Special Enrollment Period (SEP): There may be other times when you can enroll. This can include if you move, or if there’s a disaster declared by FEMA. A Special Enrollment Period is also available three months after you begin Medicaid coverage. Plus, an SEP is available for Full Benefit Dual Eligible (FBDE) individuals to align Medicaid and Medicare coverage so they’re provided by the same insurance company.
Help is here
If you have more questions or need support with enrollment, you don't have to figure it out alone. Remember, a licensed Aetna agent can help you find the best Aetna plan for you. They can help you join when the time is right and complete the enrollment process. They'll also be there for future questions.
And that support doesn’t go away once you become a member. Aetna members can call their care team for help coordinating their care. In addition, the Aetna Member Services team is available from 8 AM to 8 PM, 7 days a week.
Plus, Aetna members can call the 24-Hour Nurse Line* to get answers to health questions from a registered nurse.
*FOR NURSE LINE: While only your doctor can diagnose, prescribe or give medical advice, the 24-Hour Nurse Line can provide information on a variety of health topics.
If you qualify for both Medicare and Medicaid, you may be eligible for an Aetna® Dual Eligible Special Needs Plan (D-SNP).
*FOR PARTS OF MEDICARE: Medicare.gov. Parts of Medicare. Accessed October 1, 2026.
*FOR MEDICAID COVERAGE: Kaiser Family Foundation. 10 Things to Know About Medicaid. February 18, 2025. Accessed October 1, 2026.
Aetna Medicare is an HMO, PPO plan with a Medicare contract. Our DSNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.
Plan features and availability may vary by service area.
Participating health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. The Aetna C-SNP is available to Medicare members who have at least one of the qualifying chronic conditions. To ensure a successful enrollment process, we’ll confirm with your healthcare provider that you have one of these eligible conditions. If verification of eligible condition is not received, involuntary disenrollment will occur.
The benefit(s) mentioned are part of special supplemental benefits for the chronically ill (SSBCI). SSBCI conditions include certain cardiovascular disorders, chronic heart failure and diabetes. Eligibility is determined by whether you have a chronic condition associated with the benefit(s) and you meet all other criteria. Even if you have a listed chronic condition, you may not necessarily receive the benefit because other eligibility and coverage criteria may apply. Standards and conditions vary for each benefit. Contact us to confirm the specific SSBCI condition requirements for the benefit(s) for this plan and determine your eligibility.
For accommodation of persons with special needs at meetings, call 1-833-278-3924 (TTY: 711).
This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. Member name(s) and other details have been omitted or fictionalized to protect the member’s (members’) identity(ies). For more information about Aetna plans, refer to our website.
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