Dual-Eligible
a description for a person who is eligible for both
Medicare and Medicaid.
Dual Eligible Special Needs plan (DSNP):
a type of MA plan for people who
are eligible for both Medicare
and Medicaid
DSNP
It’s an MA plan from a private insurance carrier that combines the
benefits of Medicare and Medicaid into one cohesive plan along with
mandatory supplemental benefits (varies by plan and service area) and
coordinated care.
DSNP benefits may vary based on a person’s
income level, from partial benefits to full benefits. Be sure you
confirm the enrollee’s DSNP eligibility status level and that any
recommended plan is approved for the enrollee’s
eligibility level.
LIS Copy Waiver
Members who qualify for Extra Help (LIS status) may be eligible for a
Copay Waiver when filling at CenterWell Pharmacy or other
pharmacies.
• The waiver is authorized automatically up to the
Extra Help/LIS copay
maximum of $10.35 for 2023. Agents must
verify Extra Help status and the
member must express financial difficulty.
CenterWell Pharmacy
is a mailorder pharmacy in-network on many
Humana DSNPs.
Medicaid
Medicaid provides health coverage
for people with low incomes.
Unlike
Medicare, which most people become
eligible for at
age 65, there are no
age limits with Medicaid