Medicare & Medicaid

 Dual-eligible individuals in Missouri can enroll in a special type of Medicare Advantage plan called a Dual-Eligible Special Needs Plan (D-SNP). These plans are designed specifically for people who qualify for both Medicare and Medicaid, often referred to as "dual-eligibles." In Missouri, these plans are administered by private insurance companies that contract with Medicare. 

Coverage Integration: Dual-eligible Special Needs Plans (D-SNPs) in Missouri integrate benefits from both Medicare and Medicaid. This means that they provide all the benefits of Original Medicare (Part A and Part B), and typically also include additional benefits such as prescription drug coverage (Part D), dental, vision, hearing, and wellness programs. Additionally, they may offer benefits specific to Medicaid, such as transportation assistance and enhanced care coordination services.

Cost-sharing: Dual-eligible individuals typically have low or no premiums, deductibles, or copayments for Medicare-covered services. This is because Medicaid helps cover these costs for individuals with limited income and resources. Therefore, the out-of-pocket costs for services covered under Medicare Advantage plans for dual-eligible individuals in Missouri are often minimal or nonexistent.

Provider Network: Dual Medicare Medicaid Advantage plans in Missouri usually have provider networks, meaning you may need to use doctors and hospitals that are in the plan's network to receive full benefits. However, these plans also typically offer out-of-network coverage for emergency services and urgently needed care, ensuring access to care even if you are away from your network.

Care Coordination: D-SNPs often provide enhanced care coordination services to help manage complex health needs. This may include services such as case management, care coordination between medical and long-term care providers, and assistance with accessing community resources.

Additional Benefits: D-SNPs often provide additional benefits such as funds to purchase things such as Healthy Groceries, Utility Bills, OTC (Over The Counter items),Help with Rent, and even Pet Supplies