WASHINGTON — Virginians enrolled in both Medicaid and Medicare may qualify for a Dual Eligible Special Needs Plan, and the enrollment period is open.
The plans are available to people based on certain disabilities and income or health issues. It combines a person’s Medicare hospital and medical coverage with Medicare drug coverage while allowing the person to keep their Medicaid benefits. The program can also offer a number of additional benefits depending on the plan, such as support for healthy groceries, rides to the doctor’s office, teeth cleanings and vision checkups.
Marian Cabanillas, Community and State CEO for UnitedHealthcare, said the plans provide coordination between Medicaid and Medicare and make sure people are using the best benefits for their needs.
“What it does is make sure that the person receiving the benefits is receiving all of the services that they’re eligible for,” Cabanillas explained. “Oftentimes, people just don’t know what their benefits are. And so that care coordination is an essential portion of it, to make sure that everyone is utilizing all of their resources.”
Enrollment for dual plans opens Oct. 15 and runs through Dec. 7.
Passage of the Trump administration’s “One Big Beautiful Bill Act” could complicate matters. The legislation made $1 trillion in cuts to Medicaid, the largest in the program’s history, and added more requirements to access benefits.
Hannah Diamond, senior policy advocate for the advocacy group Justice in Aging, said there are concerns about state capacity to advance integration of the new rules, and misinformation surrounding who is and is not subject to them.
“Because of confusion about its requirements and misinformation, people duly eligible, even if they aren’t technically subject to work requirements or additional eligibility verification, could be inadvertently impacted and could lose coverage,” Diamond cautioned.
Nearly half of those who qualify across the country for a dual plan are not signed up for one.
