Millions of Americans could qualify for more health coverage.
People who are eligible for both Medicare and Medicaid can enroll in a Dual Special Needs Plan. However, many might not be taking advantage of the extra coverage.
In 2021, nearly 13 million people were enrolled in Medicare and Medicaid. But in 2023, only about five million had dual plans.
Johnny Shults, section supervisor of Medicaid program operations and integrity for the Washington State Health Care Authority, said the dual plans are known as Apple Health Medicare Connect in the state. He pointed out the biggest benefit is the plans work together.
“If you have some Medicare benefits and you want to coordinate with your Medicaid side, then if you were at the same plan they can do that all in house,” Shults explained. “Or if you have two different plans then they coordinate together to ensure that they provide that wraparound care that you need.”
Shults noted dual programs provide coverage beyond care like doctor visits and prescription drugs. They can also help with things like behavioral health care. The enrollment period coincides with open enrollment for Medicare and Medicaid, which ends Dec. 7. Shults added there is assistance available for people signing up for the plans, including with counselors at the Washington Statewide Health Insurance Benefits Advisers program.
Marian Cabanillas, spokesperson for UnitedHealthcare Community and State, said for eligible recipients, dual plans can pay for things not typically thought of as part of health care plans, such as healthy food and utility bills. She observed people tend to put off health care when they are unsure if they can afford it, and a dual plan can help alleviate the fear.
“The earlier that we can diagnose and treat issues, the better a chance you have of having better outcomes,” Cabanillas stressed.
According to UnitedHealthcare, there are no co-pays for some qualifying participants who enroll in the dual plan.
— By Eric Tegethoff, Public News Service (WA)
I have duel coverage and it
is wonderful.
I am on SSD. I had a 10 day hospital stay, in ICU, so I was very grateful for the coverage.
A cautionary tale- Please be careful and read the fine print when signing up for plans! My son, DDD client was “wooed” by UHC with promises of free groceries, access to dental care, and more. Turned out he lost access to Chiropractic care, the “dental” benefit(scant coverage like cleaning, no help with expenses like crowns or surgery costs) were difficult to obtain, many miles from home and many months to obtain appointments. RX fulfillment was a disaster. Fortunately he was able to revert back to his original Medicare plan. In his case it was not worth the free groceries. Turns out he was eligible for Apple care benefits, w/o switching to UHC.
Many people are pleased with their UHC plans, but do take the time to track benefits and details to ensure they provide what you want and need the most.