Partial-Benefit Dual Eligibility

Some individuals are eligible for Medicare cost assistance, but not full Medicaid benefits. This is often described as “partial-benefit dual eligibility” or “partial duals.” An individual in this category would often be on a Medicare Savings Program, which might cover Part A or B premiums, and some deductibles or copays. Eligibility for those programs is based on income and assets.


Medicare Advantage Plans for Partial Duals

If you are on a Medicare Savings Program, you may still be eligible for a Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP). These plans, offered by private insurance companies, bundle Medicare benefits and are designed to specifically meet the needs of people who have both Medicare and Medicaid. This allows the insurance company to designate those funds more effectively and offer additional benefits that are more specific.

These plans may include additional benefits like:

  • Dental
  • Vision
  • Hearing
  • Telehealth doctor visits via your smartphone, computer, or tablet
  • Fitness benefits, such as SilverSneakers®
  • Prescription drug coverage (Part D)
  • Meal delivery
  • Transportation to and from doctor visits
  • Over-the-counter allowance for products such as vitamins, toothpaste, and allergy medicine

Find Medicare Advantage Dual-Eligible Special Needs Plans That May be Available in Your Area

Call 1-855-918-3272 / TTY 711

To speak to a licensed insurance agent

Mon - Thurs 8am - 11pm EST and Friday 8am - 9pm EST