Who can qualify for a dual-eligible health plan or Dual Special Needs plan?

“Dual-eligible” means you qualify for both Medicaid and Medicare health insurance programs. You may also hear this type of eligibility called “D-SNP eligibility” or “Medicare SNP eligibility” since Dual Special Needs plans are a type of Medicare Advantage plan.

So, what exactly does it take to qualify for a dual-eligible health plan? These plans are also known as Dual Special Needs plans. If you can answer “yes” to all of the questions below, chances are you qualify for a dual-eligible health plan.

The Medicaid health care program for your state is managed by your state government. The rules to qualify for Medicaid depend on your state. Do you get financial help such as supplemental security income (SSI)? If you have low income, you may qualify for Medicaid.

To find out if you can get Medicaid in your state, check with your state Medicaid agency. You’ll find a link to the website for your state Medicaid agency on the “Plan Details” page for each of our health plans. To see the health plans we offer in your area, please search plans in your state.

Medicare is a national health insurance program run by the federal government. It’s for people age 65 and older, and also some people under age 65 with certain disabilities. To be eligible for Medicare, you also have to be a U.S. citizen or a legal resident who has lived in the U.S. for at least 5 years.

Medicare Part A is hospital insurance. Medicare Part A covers services that you may get as an inpatient during a stay in hospital or a skilled nursing facility. Medicare Part B is medical insurance. Medicare Part B covers doctor services and preventive care. Together, Medicare Parts A and B are also known as Original Medicare. Learn more about the 4 different parts of Medicare.

What dual-eligible plans you can qualify for depends on where you live. Your home address needs to be in the dual plan’s coverage area to be eligible for that specific dual-eligible health plan. To find a UnitedHealthcare Dual Complete® plan for you, please search plans in your state. 

Do you qualify for both Medicare and Medicaid? You may be eligible to qualify for a dual eligible plan if:

• You qualify for Medicaid in your state
• You qualify for Medicare Parts A and B (Original Medicare)
• You live in the dual-eligible plan’s coverage area