Dual Special Needs Plans (D-SNPs) in West Virginia

Dual Special Needs Plans (D-SNPs) in West Virginia are specialized Medicare Advantage plans for people with both Medicare and Medicaid. They typically offer many extra benefits and features beyond the original Medicare.

What makes Dual Special Needs Plans different?

Medicaid is a joint Federal and state government program. Dual Eligible Plans also contain help

to correspond care.

D-SNPs With or Without Medicare Zero-Dollar Cost Sharing

At the time of plan creation, each D-SNP must identify whether or not if offers Medicare zero-dollar cost sharing.  In HPMS, D-SNPs will have the option of one of the following two indicators:

  1. Medicare Zero-Dollar Cost Sharing Plan, or
  2. Medicare Non-Zero Dollar Cost-Sharing Plan.

Dual Special Needs Plans (D-SNPs) in West Virginia typically include additional benefits like:

  • Dental Coverage
  • Prescription Drug Coverage
  • Health Product and Over-the-Counter item Credits
  • Food Allowance
  • Vision Coverage
  • Transportation Services
  • Fitness Programs

Is Dual Special Needs Plans (D-SNPs) in West Virginia right for you?

It may be right for you if…

  • You have full Medicaid Benefits and Medicare
  • You have complicated medical needs
  • You need help with corresponding care
  • You’d like additional benefits

What are the Eligibility Requirements for a Dual Special Needs Plan?

  • You have both Medicare Part A and Medicare Part B
  • You live in the geographic service area of your selected plan
  • You are a US citizen or are lawfully present in the US
  • You are eligible for one of the following Medicaid Savings Programs:
    • Qualified Medicare Beneficiary
    • Specified Low-Income Medicare Beneficiary Plus
    • Full Benefit Dual Eligible

D-SNPs With or Without Medicare Zero-Dollar Cost Sharing

At the time of plan creation, each D-SNP must identify whether or not if offers Medicare zero-dollar cost sharing.  In HPMS, D-SNPs will have the option of one of the following two indicators:

  1. Medicare Zero-Dollar Cost Sharing Plan, or
  2. Medicare Non-Zero Dollar Cost-Sharing Plan.

These two indicators will be used in multiple areas within HPMS and are essential to the proper display of benefits in Medicare Plan Finder.

How do I learn more about Medicaid Eligibility?

Contact the West Virginia Medicaid office: at 1-800-318-2596

  • Call: 1-800-318-2596 8:00am– 5:00pm Monday through Friday

Website:https://dhhr.wv.gov/bms/Members/Apply/Pages/default.aspx