What does "Dual-Eligible" mean in the context of D-SNPs?

"Dual-Eligible" refers to individuals who qualify for both Medicare and Medicaid. This designation is significant because it allows these individuals to receive a broader range of healthcare services and benefits than they might have access to with either program alone. In the context of D-SNPs (Dual-Eligible Special Needs Plans), these plans are specifically designed to cater to the unique needs of individuals who are eligible for both Medicare and Medicaid, providing tailored benefits and care coordination.

Individuals who are dual-eligible can take advantage of Medicare's services, such as hospital coverage and outpatient care, alongside Medicaid's assistance, which can include coverage for long-term care, additional medical expenses, and wraparound services not covered by Medicare. This combination enhances their overall access to medical care, ensuring they receive the necessary support for both chronic conditions and overall health management.

Other options do not accurately represent the definition of "Dual-Eligible." For instance, being eligible for private insurance doesn't encompass the dual nature of having both Medicare and Medicaid, and solely qualifying for Medicare or Medicaid excludes the comprehensive coverage that comes from being dual-eligible. Thus, the correct definition centers on the eligibility for both Medicare and Medicaid.