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“Discover D-SNP Coordinated Care & Wellness Benefits for Eligible Families”

Dual Eligible Special Needs Plan (D-SNP)

Changes Coming Soon:

Starting January 1, 2026, Tennessee will begin moving Full Benefit Dual Eligible (FBDE) individuals into Fully Integrated Dual Eligible Special Needs Plans (FIDE D‑SNPs).

  • This applies to people who currently receive Medicare and Medicaid benefits from the same health plan.

  • Any newly eligible FBDE person who enrolls in a D‑SNP must enroll in a FIDE D‑SNP. This process is called exclusive aligned enrollment.

  • By 2030, all FBDE individuals must receive both Medicaid and Medicare benefits from the same health plan.

If you are enrolled in a Coordination‑Only (CO) D‑SNP that is not aligned with your Medicaid Managed Care Organization (MCO), you can keep this plan until January 1, 2030. After that, you will be automatically disenrolled and placed into Fee‑for‑Service (original) Medicare. To avoid this, you can change your Medicaid MCO to align with your D‑SNP MCO.

What is a D-SNP

A Dual Special Needs Plan (D-SNP) is a type of Medicare Advantage plan designed for individuals who qualify for both Medicare and Medicaid. These individuals are often referred to as “duals” or “dual eligibles.”

  • All duals have Medicare Part A, Part B, or both.

  • They may have full or partial Medicaid.

  • Partial duals (such as QMB-Only) can still enroll in a D-SNP if they receive state assistance with Medicare premiums or cost sharing.

Why D-SNPs Matter

Dual Eligible Individuals often live with serious or chronic health conditions, leading to higher healthcare cost. Managing both Medicare and Medicaid alone can be overwhelming.

A D-SNP helps by coordinating benefits across both programs, giving members access to:

  • Medical care

  • Behavioral health services

  • Prescriptions

  • Long-term services and supports

  • Other vital benefits

A D-SNP helps its members manage their healthcare needs and costs by offering:

  • An Interdisciplinary Care Team (ICT): A group of healthcare professionals involved in the member’s care.

  • A Coordinator: A main point of contact to assist members in accessing the healthcare services they need.

  • An Annual Health Risk Assessment: A review of the member’s health to help create a care plan that meets their needs.

  • An Individualized Care Plan: A personalized plan that tracks the member’s health conditions and outlines the care provided and planned, ensuring their healthcare needs are met.

  • Additional Supplemental Benefits: Beyond traditional Medicare. This could include long-term services and supports, durable medical equipment (oxygen equipment, mobility aids, blood sugar monitors, etc.), enhanced dental, vision, and hearing benefits, and monthly food and/or utility allowances.

*Notice: TennCare is not responsible for payment for these benefits, except for appropriate cost sharing amounts. TennCare is not responsible for guaranteeing the availability or quality of these benefits.

Types of D-SNPs in Tennessee - currently Tennessee offers two types of D-SNPs

  1. A Fully Integrated Dual Eligible or “FIDE” SNP plan manages both Medicare and Medicaid benefits under one healthcare provider. A FIDE SNP is the most integrated D-SNP option for dually eligible individuals. Members receive a single member card, one handbook, an integrated provider directory, combined notices, and access to a unified appeals process. This plan is also known as an “aligned plan”

  2. A “Coordination-Only (CO)” D-SNP is a plan that covers a member’s Medicare benefits and services through the D-SNP and must work with TennCare Managed Care Organizations (MCOs) to manage the member’s Medicaid benefits. A CO D-SNP’s enrollment is limited to Qualified Medicare Beneficiaries (QMB) and 1915(c) members-only.

TennCare encourages individuals to enroll in their TennCare Health Plan’s D-SNP plan to simplify the coordination of both Medicare and Medicaid benefits through one healthcare provider.

How do I qualify for D-SNP? - You may qualify if you:

  • Have Medicare Part A and B or receive assistance from a qualifying Medicare Savings Program

  • Receive TennCare Medicaid

  • Live in Tennessee

How do I apply?

If you have both Medicare and Medicaid, Tennessee offers 6 D-SNP plan options for 2025. You can find each plan profile along with contact information in the D-SNP Comparison Chart.

D-SNP Plan Documents

Members enrolled in a D-SNP can quickly access member documents for each plan by viewing the D-SNP Webpage Resource Links.