Dual Eligible Special Needs Plans (D-SNP)
Our Dual Special Needs Plan (D-SNP) is designed for those who qualify for Medicare and full Medicaid, are over the age of 21 years old, and reside in one of four Utah counties: Davis, Salt Lake, Weber, and Utah
View D-SNP Information for Members
Select Health reimburses providers at 100% of Medicare rate for service for D-SNP members.
What is D-SNP?
Dual eligible special needs plans (D-SNPs) are a type of Medicare Advantage plan designed to meet the specific needs of people who qualify for both Medicare (i.e. title XVIII) and medical assistance from a state plan under Medicaid (i.e. title XIX). States cover some Medicare costs, depending on the state and the individual's eligibility.
What are the benefits of D-SNP plans?
For the provider: Select Health reimburses providers at the 100% Medicare rate for preventive and office visits under this plan type.
For the member: This plan helps lower-income members cover costs for which they wouldn’t otherwise have coverage. For example, they can access dental, vision, hearing aid, help in the home, over-the-counter medicines, all of which are not covered by Medicaid. In addition, a D-SNP plan allows older members who have special needs, such as chronic illnesses or financial challenges, to have broader access to care.
For Select Health: Offering a D-SNP supports our mission to help people live the healthiest lives possible through a value-based care approach. This plan requires that we develop a detailed Model of Care (MOC) for CMS approval that includes these measures for the Care of Older Adults (COA):
- Advance Care Planning
- Medication Review
- Functional Status Assessment
- Pain Assessment
These measures help us better collaborate with providers on establishing a standard of care for D-SNP members and all members age 66 years or older.
How can Providers Participate?
- Join the Select Health Medicare Network: Contact your Provider Relations representative if you are not currently participating in our Medicare network.
- Already a Select Health Medicare provider? Access the 15-minute D-SNP Model of Care Abbreviated Training available online. This required training covers the basics of D-SNP plans, MOC elements, and standards.
- Learn about the COA measures and how to incorporate them into your practice workflow. Download a guide to required documentation and coding.
- Recommend the D-SNP to your patients who qualify for Medicare and full Medicaid. Please share this flyer about extra benefits with your patients who qualify. SelectHealth members can call the Answer Team at 855-442-9940 (TTY: 711) to get started.