I've been doing Medicare reviews long enough to recognize a pattern: the people who need the most help are the ones who've been told the least.
One of the biggest gaps I see every week — across Massachusetts and the other states I work in — is this: thousands of people who qualify for a Dual Special Needs Plan (D-SNP) have never heard of it. They're paying out-of-pocket for copays, dental work, and transportation that could be covered at zero cost.
This article is going to fix that.
The short version: If you have both Medicare and Medicaid, you are "dual eligible" — and you may qualify for a D-SNP plan with $0 premium, $0 primary care copays, dental, vision, hearing, free rides to appointments, and over-the-counter allowances. Most people who qualify don't know these plans exist.
A Dual Special Needs Plan (D-SNP) is a type of Medicare Advantage plan designed specifically for people who receive both Medicare and Medicaid benefits. These plans are approved by CMS (the Centers for Medicare & Medicaid Services) and offered by private insurance companies under contract with Medicare.
Because beneficiaries who qualify for both programs often have complex health needs and limited incomes, D-SNP plans are built to provide significantly more comprehensive coverage than standard Medicare Advantage or Original Medicare.
Eligibility is straightforward: you must be enrolled in both Medicare (Parts A and B) and a Medicaid program in your state.
In Massachusetts, Medicaid is called MassHealth. If you have MassHealth in addition to Medicare, you are dual eligible and may qualify for a D-SNP.
You may be eligible even if:
Benefits vary by plan and carrier, but here's what D-SNP plans commonly include in Massachusetts:
Both are types of Medicare Advantage plans. The key differences are:
This is the question I get asked most after someone discovers they've been eligible for years and never enrolled.
The honest answer: the system doesn't always do a great job of finding the people who need it most.
D-SNPs are not automatically assigned. You have to enroll. And enrollment requires knowing the plan exists, understanding you qualify, and finding a carrier that offers it in your zip code.
Many brokers steer people toward whatever plan pays the highest commission, not necessarily the best plan for the client. Independent brokers — like me — can shop every carrier in your area and find the option that actually fits your situation.
The fastest way: call me. A Medicare review takes about 20 minutes over the phone, and I'll tell you exactly which plans are available for your situation, your zip code, and your doctors.
If you want to check on your own first:
I'll check every D-SNP available in your area, compare the benefits side by side, and tell you honestly if it's a better option than what you have now. No cost. No pressure.
Request My Free ReviewOr call: (774) 446-0701 | Webster, MA | Licensed in MA, CT, NJ, NY, NC, FL, TX, ME
I've worked with clients who were spending $80–$150/month on copays, dental, and OTC health products — all of which would have been fully covered under a D-SNP they qualified for but no one had ever mentioned.
That's money that could have stayed in their pocket. That's exactly what "People Over Profits" means to me in practice: making sure the people who need help the most actually get the coverage that's available to them.
If you're dual eligible and you haven't had a Medicare review recently, schedule one. It's free, it takes 20 minutes, and it might change your situation permanently.
Uhia Willis is an independent licensed Medicare and life insurance broker based in Webster, MA. He is the founder of Willis Advocacy Group (UKW Consulting Inc.) and is licensed in MA, CT, NJ, NY, FL, TX, and NC. He specializes in dual-eligible beneficiaries, clients with complex health histories, and anyone who has been underserved by the insurance system.