A quick guide to Special Needs Plans (SNP)
SNP's designed for Dual Eligible Medicare Beneficiaries.
Dual Special Needs Plan is the most common and widely available Special Needs Plan in Washington State. They are specifically designed to provide additional benefits for low income Medicare Beneficiaries. For more details on how they work, go to our Low Income Assistance page for information.
Can I get my health care from any doctor, other health care provider, or hospital?
Most DSNP's available in Washington State do have a network of providers that you must use to get your care. Current plans have such extensive networks that it's uncommon to run into issues finding or keeping doctors. Please contact us for more information on specific plans available.
Are prescription drugs covered?
Prescriptions drug coverage must be included with all DSNP plans. Those that qualify for such plans will also be enrolled in Medicare's Extra Help Program. If someone is currently only enrolled in Original Medicare and a stand alone Prescription Drug Plan may feel concerned that joining a DSNP may affect their low cost drug costs currently enjoyed. This is not an issue, as it's the Extra Help Program that establishes drug pricing and is not altered by adding a DSNP.
Do I need to choose a primary care doctor?
While you are asked to choose a primary care physician, your choice of doctor is YOUR choice and can be changed at any time. Some plans do not require a referral, like with some HMO's, allowing for simplified appointments and management of care.
Do I have to get a referral to see a specialist?
Sometimes the specialists want one for professional courtesy, but some plans do not require it.
What else do I need to know about this type of plan?
- Since enrollment into a DSNP requires dual eligibility of Medicare and Medicaid it will not affect enrollment in those Government programs. Just as it will not affect drug pricing.
- DSNP plans are designed to give unparalleled, additional benefits that enhance what may be available through Medicaid. Benefits may include some of the following: dental, vision, hearing, transportation assistance, gym membership, health product catalog that includes allowances for over-the-counter pharmaceuticals, food allowance, specialized assistance for accessing services, some forms of alternative medicine, and more.
Still have questions, or need more information on how to pick the plan that is right for you?