Dual Eligible Special Needs Plans (D-SNPs) are a type of Medicare Advantage plan specifically designed for people who qualify for both Medicare and Medicaid. In New Mexico, where a significant portion of Medicare beneficiaries are also enrolled in Turquoise Care (Medicaid), D-SNPs provide a streamlined way to coordinate benefits from both programs in a single plan.
What Is a D-SNP?
A D-SNP combines your Medicare Part A, Part B, and usually Part D prescription drug coverage into one plan, while also coordinating with your Medicaid (Turquoise Care) benefits. D-SNPs are required to have contracts with the state Medicaid agency, ensuring that your Medicare and Medicaid benefits work together seamlessly.
Benefits of D-SNPs in New Mexico
- $0 or low premiums: Most D-SNPs have $0 monthly premiums beyond your Part B premium
- $0 or low copays: Reduced cost-sharing for doctor visits, hospital stays, and prescriptions
- Coordinated care: One plan manages both your Medicare and Medicaid benefits
- Extra benefits: Many D-SNPs include dental, vision, hearing, transportation, over-the-counter allowances, and meal delivery
- Care coordination: Dedicated care coordinators help manage your health needs
- Prescription drug coverage: Part D included with low or $0 copays for dual-eligible members
Who Qualifies for a D-SNP?
To enroll in a D-SNP in New Mexico, you must:
- Be enrolled in Medicare Part A and Part B
- Be enrolled in or eligible for New Mexico Medicaid (Turquoise Care)
- Live in the plan's service area
Enrollment flexibility: Dual-eligible beneficiaries qualify for a Special Enrollment Period (SEP) that allows them to enroll in, switch, or leave a D-SNP once per quarter during the first three quarters of the year (January–September). This gives you more opportunities to find the right plan.
D-SNP vs. Regular Medicare Advantage
| Feature | D-SNP | Regular MA Plan |
|---|---|---|
| Eligibility | Must have Medicare + Medicaid | Must have Medicare Parts A & B |
| Medicaid Coordination | Required; integrated benefits | No Medicaid coordination |
| Cost-Sharing | $0 or very low | Varies; can be significant |
| Care Coordination | Required; dedicated coordinator | Available but not required |
| Extra Benefits | Often more generous for low-income members | Varies by plan |
| SEP Access | Quarterly enrollment changes | Generally limited to AEP/OEP |
How to Enroll in a D-SNP in New Mexico
D-SNP availability varies by county. To see which D-SNPs are available in your area and compare their benefits:
Already on Turquoise Care and Medicare?
If you currently have both Medicare and Turquoise Care but are not enrolled in a D-SNP, you may be missing out on significant extra benefits and better care coordination. A licensed Medicare agent can review your current coverage and show you what D-SNP options are available in your county at no cost.