Which group is eligible for D-SNP plans?

D-SNP, or Dual Eligible Special Needs Plans, are specifically designed for individuals who qualify for both Medicare and Medicaid. This group, referred to as "dual eligibles," typically includes those who receive full benefits under Medicare along with comprehensive Medicaid services.

This is essential as D-SNPs tailor their services to meet the unique needs of these individuals, who often have complex healthcare requirements due to various factors, including socioeconomic challenges and chronic health conditions.

Individuals with only Medicare benefits or those who have private insurance do not meet the eligibility criteria for D-SNPs, as these plans are not aimed at addressing their specific needs. Similarly, those with chronic conditions alone may not necessarily qualify unless they are also dual eligible, reinforcing why the eligibility for D-SNP plans specifically hinges on being a Medicare plus full Medicaid beneficiary.