Health and health insurance terms are confusing enough. But when you have both Medicaid and Medicare it adds a whole new level. At UnitedHealthcare, the promise to help make things simpler guides everything we do. In this article, we want to make it simpler to understand some of the key points about dual health plans.
Dual is just another way of saying “two” or “both.” In the case of dual health plans, dual means that these plans are for people who have both Medicaid and Medicare. “Dual-eligible” is a term that describes people who are eligible, or who qualify, to receive both Medicaid and Medicare benefits. These people are also known as “dual-eligible.”
Zip. Zero. Nada. There’s no difference. Whether you use dual plan, dual health plan, dual special needs plan or even the shorthand DSNP, all these terms mean the same thing. They describe the type of health plan that’s specially designed to meet the needs of people who have both Medicaid and Medicare.
This point confuses a lot of people, but the answer is no. A dual health plan doesn’t replace your Medicaid plan. You’ll keep your Medicaid plan, and you’ll still get all the same Medicaid benefits you get now. A dual health plan is a type of Medicare Advantage plan. It will replace your current Medicare plan. Plus, it includes prescription drug coverage and many other benefits and features you don’t get with Original Medicare. For more details, see More benefits than Original Medicare
There are rules that control when you can enroll in a dual health plan. View the "When to Enroll in a Dual Health Plan" article. If you become newly eligible for Medicare, or you have a qualifying life event (such as moving into or out of state) you can enroll using a Special Enrollment Period (SEP). The Medicare Annual Enrollment Period (AEP) is from October 15 thru December 7 every year. Anyone who’s eligible can enroll in or switch their Medicare plan. That includes if you want to switch from just Original Medicare to a dual health plan.
Also, you don’t need to renew a dual health plan. As long as you stay eligible, your dual health plan will renew automatically each year. But you do need to recertify for Medicaid every year to stay qualified for a dual health plan.
“Dual Complete” is the brand name for the dual health plans offered by UnitedHealthcare. UnitedHealthcare has been serving people with special heath care needs for more than 40 years. Today, UnitedHealthcare serves more dual-eligible members in more states than any other health care company.1
1Based on national market share, as of 2019
UnitedHealthcare has a free online listing of thousands of medical terms and their meanings. It’s called Just Plain Clear and it’s the largest glossary of its kind.
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Please note that the specific benefits dual health plans include can change depending on where you live. Search by your ZIP code to find the right plan to meet your health care needs.