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2020 market expansion: Dual Special Needs Plans (DSNPs)

 

We’re excited to announce the expansion of our DSNPs into more markets for 2020.

 

If you are contracted for Medicare Advantage HMO products, you are in our DSNP network.*

 

The DSNP network is available in limited states and counties. Check your participation status using our Provider Search tool

Policies and procedures

All DSNPs are required to have an approved Model of Care. The Centers for Medicare & Medicaid Services (CMS) requires Model of Care training upon initial participation and annually thereafter.

 

Member eligibility and benefits

Members should follow these steps to become eligible for benefits:

 

  1. Show their DSNP member ID card and state-issued Medicaid card
  2. Select a primary care physician
  3. Follow the approval process for out-of-network benefits (they need to contact

 

Member Services directly)  

 

Provider claims processing

Member cost sharing: Depending on the member’s Medicare Savings Program (MSP) eligibility, they may have a cost share responsibility. You may not balance bill members (including Qualified Medicare Beneficiary-only members) who do not have cost share responsibility. For more information, go to the 2020 DSNP Provider Cost Share Grid.

 

To contact us, go to the 2020 DSNP Service Area Guide.

 

 *VA only: Please review your contract or contact our Provider Service Center at 1-855-463-0933 (TTY: 711) to find out about your network participation.