To enroll into a D-SNP, your client must be eligible for both Medicare and Medicaid. The below information will help you determine the right UHC D-SNP based on their Medicaid eligibility, or another UHC Medicare advantage plan option if they are not Medicaid eligible.
To be eligible for a D-SNP the consumer must be:
- Enrolled to Medicare Part A
- Enrolled in Medicare Part B
- United States citizen or lawfully present in the United States (e.g. Permanent Residents)
- Receive state Medicaid benefits *
- Reside in the plan’s Service Area *
*Note: Please review your Sales Materials (e.g., Enrollment Guide, Summary of Benefits) for specifics on qualifying Medicaid categories and service area for the D-SNP.
MMV is a Jarvis tool where you can verify your client’s Medicare and Medicaid eligibility. To verify Medicaid eligibility, you will need your client’s name, state, date of birth, and Medicaid number. Medicaid searches also provide a list of plans available for enrollment based on their Medicaid level and residence (i.e., the plans offered in their state, county, and zip code). Click here to check the tool status for your state.
Note: the MMV tool does not provide the specific Medicaid program for which your client is eligible (e.g. FBDE, QMB+ SLMB+). Instead, it indicates whether your client is Full Dual eligible, QMB, or Partial Dual.
Some D-SNPs are designed for individuals that qualify for or are enrolled in Long Term Services and Supports or Long-Term Care (LTSS/LTC).
These individuals must be eligible for, and often must be enrolled in, their state’s LTSS/LTC program to sign up for a UHC LTC/LTSS plan. See the definitions section below for more on LTSS/LTC.
UnitedHealthcare aims to offer a portfolio of Medicare products in all markets. If the consumer is not eligible for a D-SNP, many markets have a Chronic Special Needs Plan (C-SNP) to meet the needs of Medicare eligibles living with diabetes, cardiovascular disease, or chronic heart failure. And most markets also offer a non-SNP plan which any Medicare eligible can enroll into for a low or no monthly premium with reliable coverage for medical and prescription drugs, plus valued extras like dental, vision, and hearing care. Please navigate to the Medicare Product Portal below to explore additional options.
A website where you can search, view, and compare UnitedHealthcare Medicare Advantage plans.
Selling D-SNP
Once you’ve verified your client’s D-SNP eligibility (See the ”D-SNP Eligibility” section above), you are then able to enroll the client into a UHC D-SNP. See the below table for when you can enroll eligible clients into a D-SNP.
| Selling Circumstance | Time | Selling Restrictions |
|---|---|---|
| AEP | October 15 – December 7 | None, except for one plan in New Mexico and Hawaii, which each require Full Dual eligible members to enroll in UHC Medicaid first (see the state's D-SNP Enrollment at a Glance guide linked below.) |
| Medicare Open Enrollment Period (OEP)– only for consumers who have Medicare Advantage |
January 1 – March 31 | Switch to another Medicare Advantage plan with or without drug coverage. |
| Integrated SEP | Year-Round | Yes, state-dependent. See the state At-A-Glance documents below. |
Special Circumstances SEP |
Year-Round |
Click here for more information |
