Which plan type is commonly used to coordinate Medicare and Medicaid when dual eligibility exists?

• A. Traditional Medicare Advantage plan.
• B. Medicare Plan with Special Needs only for employers.
• C. D-SNP plans (Dual Eligible Special Needs Plans) designed with specialized rules.
• D. Standalone Medicare Prescription Drug Plan.

Answer: (C)

Dual eligibility means a person qualifies for both Medicare and Medicaid, so the plan designed to coordinate benefits across both programs is a Dual Eligible Special Needs Plan. D-SNPs are Medicare Advantage plans tailored to dual eligibles, with specialized rules and structures that align Medicare and Medicaid benefits, often including integrated care management, Medicaid-driven networks, and simplified benefits coordination. This setup helps ensure services from both programs work together smoothly and reduces gaps in coverage. Traditional Medicare Advantage plans cover Medicare benefits but aren’t specifically built to coordinate with Medicaid. A standalone Medicare Part D plan handles only prescription drugs and doesn’t address Medicaid benefits. An employer-specific plan labeled as a special needs plan isn’t the standard option for dual eligibles. So the best choice is Dual Eligible Special Needs Plans.