Dual health plans: Designed to make life easier
It’s not easy for the average person to find their way through the health care system. But it’s much more difficult for those who are elderly or have complex health conditions. And for those who also rely on government-assisted health care like Medicare or Medicaid, it’s even harder. What plan covers what, which bills are which — it can get very confusing.
Dual health plans are designed to help make life easier for those who have both Medicaid and Medicare. These people are known as “dual-eligible” because they’re eligible to have Medicaid and Medicare at the same time. Dual plans are also known as dual special needs plans or DSNP for short. These names all mean the same thing.
More coverage than either Medicaid or Medicare alone
Dual plans are for people who could use some extra help. That may be because of income, disabilities, age and/or health conditions. Dual plans are a type of Medicare Advantage plan. They work together with state Medicaid plans. With a dual plan, members keep the same Medicaid benefits they get today.
Dual plans must provide the same coverage as Original Medicare. Original Medicare covers hospital stays and doctor visits. But most dual plans also include extra benefits and features. Things like dental, vision and hearing coverage, and much more. As a result, a dual plan can help members cover more of their care and costs. Members may also enjoy more choice and flexibility when it comes to doctors, hospitals and prescription drugs.
The leading dual plan in America1
Dual special needs plans are offered by private insurance companies. That includes UnitedHealthcare, which calls its dual plan UnitedHealthcare Dual Complete®. This is the most popular plan of its kind in America.1 UnitedHealthcare has been serving people with special heath care needs for more than 40 years. Today, UnitedHealthcare serves more dual-eligible members in more states than any other health care company.1 And that includes here in New York State.2
Extra benefits at no extra cost
With UnitedHealthcare Dual Complete, New Yorkers can enjoy many extra benefits and features for a $0 plan premium. In fact, according to current members, the top five benefits are:
1. $1,440 in credits to buy health products with their OTC Network card.
2. Dental care with $2,000 for dentures, root canals and other dental work.
3. 48 one-way rides each year to take care of health needs.
4. Hearing coverage with a yearly exam and $1,000 credit every two years for hearing devices.
5. Vision coverage with a yearly exam and $300 credit every two years for eyewear.
The added benefit of care coordination
Care coordination is another big benefit that members get with UnitedHealthcare Dual Complete. Each member is assigned a personal care coordinator. This is someone who gets to know the member and works with them, their family, caregivers and doctors to help coordinate care.
A personal care coordinator helps each member with their individual health challenges. They make sure the member understands their Medicaid and Medicare benefits. They help manage all their doctors, specialists and care services. And they make sure members get all the services they qualify for.
Given how much simpler dual plans can make life for members, it’s not surprising that they’re becoming more and more popular. Indeed, UnitedHealthcare is seeing big increases in its Dual Complete plans across the country and also in New York state. In Erie County alone, the company’s dual plan enrollment has grown more than four times since 2016 to nearly 4,700 members today. The company also reports rapid growth in Chautauqua, Genesee, Orleans and Wyoming counties, where UnitedHealthcare has only offered dual plans for the last two years.
According to the Centers for Medicare & Medicaid Services (CMS), there are about 12 million Americans who are dually eligible for Medicare and Medicaid.3 But only a fraction of these people are currently enrolled in a dual plan. The main reason is that many people who are eligible to get a dual health plan may not know that they exist.
Is a dual plan right for you or someone you know?
Most people who enroll in a dual plan find it easier when they have someone to help guide them. That’s where a licensed sales agent comes in. These representatives will go over everything with you step by step. They’ll look at what you have now. They’ll compare that with all the other choices available. And they’ll take time to answer your questions and explain it all clearly and carefully.
If you’d like to talk with a licensed sales agent at UnitedHealthcare, call 1-855-671-4175, TTY 711. You can also see what UnitedHealthcare Dual Complete plans are available where you live, and the benefits they provide on the company’s website.
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare.
1, 2 Based on State/national market share, as of 2018.