What is Medicare partial dual eligibility?

What is Medicare partial dual eligibility?

Having the right type of Medicare plan for your unique medical needs and budget is important, but not always easy to find. Some people with income or assets over the limits for full Medicaid may be eligible for one of the Medicare Savings Programs (MSP). These federally funded, state-administered programs may pay for part or all of their Medicare Parts A and B premiums, deductibles, coinsurance, and copayments for services and items Medicare covers. This type of Medicare is called a dual-eligible special needs plan (D-SNP).

Types of MSPs

There are different types of MSP options in Virginia: 

• Qualified Medicare Beneficiaries (QMBs)
• Special Low Income Medicare Beneficiaries (SLMBs)
• Qualified Disabled Working Individuals (QDWIs)
• Qualifying Individuals (QIs)

If you qualify for one of these, the Virginia Department of Medical Assistance Services (DMAS) may pay for part or all of your Medicare premiums and copayments. If you’re not sure what you qualify for, one of our Licensed Plan Advisors can help. Call tel:1-877-550-3285 (TTY: 711), October 1 through March 31, 7 days a week from 8 a.m. to 8 p.m. and April 1 through September 30, Monday through Friday from 8 a.m. to 8 p.m.

To learn more, you can also visit www.dmas.virginia.gov.

Sentara Medicare Partial D-SNP

You may qualify for Sentara Medicare’s partial D-SNP, Sentara Community Complete Select (HMO D-SNP) if you are a QMB within the Medicare Savings Program. By enrolling in our $0 premium D-SNP plan, you’ll get more benefits than having Original Medicare alone. Plus, you’ll receive a care coordinator focused on your unique needs.

Extra benefits: Sentara Medicare D-SNP members get extra benefits at no cost to them. These extra benefits could include, but aren’t limited to:

• Monthly grocery allowance for members with a qualifying chronic condition1
• Quarterly over-the-counter products allowance
• Dental coverage, plus allowances to help pay for certain dental services
• Vision coverage, including an allowance for glasses or contacts 

Healthy Rewards program

Earn extra reward dollars for completing healthy activities through the Sentara Medicare Healthy Rewards program.2 Amounts earned will be loaded on a prepaid flex card. It works like a debit card, so you use it toward utility or phone bills.

Take the next step

Sentara Medicare is here to help you, family members, and caregivers learn more about partial dual eligibility and the other types of Medicare Advantage plans. If your status changes to full dual eligible, you can change to the Sentara Medicare full D-SNP plan, Sentara Community Complete (HMO D-SNP).
One of our friendly Licensed Plan Advisors can help you find which plan fits your eligibility. We can help answer your questions and enroll. You can also find more information on our website at www.sentaramedicare.com/dsnp. 

1-877-550-3285 (TTY: 711)

October 1–March 31 | 7 days a week | 8 a.m.–8 p.m.

Benefits vary by plan and region.1 Members with chronic condition(s) that meet certain criteria may be eligible for this special supplemental benefit.2 Rewards cannot be used to buy tobacco or alcohol. Rewards cannot be converted to cash. You can only receive one reward per applicable service per plan year. H2563_1124_SHPPD_460099_C