What Are D-SNPs and Why Should You Consider Selling Them?

D-SNPs are a type of Medicare Advantage (MA) Special Needs Plan. Most D-SNPs are health maintenance organization (HMO) plans, though some are preferred provider organization (PPO) plans. 

What are the levels of D-SNP/Medicaid Eligibility?

  1. Qualified Medicare Beneficiary (QMB) and QMB+) – helps pay premiums, deductibles, coinsurance, and copayments for Part A, Part B, or both programs.
  2. Specified Low-Income Medicare Beneficiary (SLMB) and (SLMB+) – help pay Part B premiums.
  3. Qualifying Individual (QI) – helps pay Part B premiums.
  4. Qualified Disabled Working Individual (QDWI) – pays the Part A premium for certain disabled and working beneficiaries.
  5. FullBenefit Dual Eligible (FBDE)- individuals who fall into this program and QMB+ are eligible for full Medicaid Benefits.

How Can You Check for D-SNP Eligibility?

Carrier sites usually have an eligibility link. To confirm your client’s eligibility level, you will need some information about them. Each carrier requires different things, so you should gather data before visiting the carrier sites. It would be great if you had information like full name, DOB, Medicaid # or SSN, MBI, State they reside in, gender, etc.

Humana and UnitedHealthcare both have great sites to check for eligibility.

Do all Carriers offer plans for all Medicaid Levels?

Absolutely not! Each carrier files its plans with the state and CMS. The carrier decides what levels of Medicaid they want to cover for the D-SNP plans they offer. While you can check Medicaid levels on the various carrier sites, ensure your client’s plan covers their specific level. You will find this in the Summary of Benefits.

When Can You Sell D-SNPs?

Although D-SNPS is a Medicare Advantage plan, they have a rolling SEP. Beneficiaries are eligible to join or switch plans once per quarter for the year’s first three quarters. During the last quarter of the year, they can enroll using AEP as their enrollment code. Of course, this needs to follow the timeline of AEP, October 15th – December 7th, for a 1/1 effective date.

Where Can You Find D-SNP Prospects?

There are so many places and ways to work with the D-SNP community. Grassroots marketing is an excellent approach to get started. Grassroots marketing involves lots of community involvement while providing a solution. 

Here are some ideas of places you can get plugged into:

  • Senior Expos and Health Fairs
  • Retirement Communities
  • Churches, Soup Kitchens
  • Senior Housing
  • Host Educational or Sales Events

Stay compliant by following the CMS guidelines when attending these places or hosting events. If you need clarification on these guidelines or help getting started, contact your UIG Sales representative.


PRO TIP #1: Most carriers offer D-SNP training. To better understand the market, take one or two training courses. If you need help finding the training, please reach out to UIG! 

PRO TIP #2: Utilize your resources at UIG. We can help you get started in this market and with client case prep!

PRO TIP #3: Growing your D-SNP book takes time. It takes an average of seeing something seven times before someone takes action. Be in it to win it! The D-SNP market is very loyal once you get your foot in the door and allow them to trust you as an agent. 

By positioning yourself as a resource inside this community, you will become a familiar face to those around this community. Many folks in this community are underserved, so spending time developing trust with them will grow your D-SNP clients and help you obtain referrals. It is gratifying when you have helped someone, especially those who are underserved, get the coverage and protection they need! Continuously showing up and providing excellent customer service will benefit not only you but this community as well. 

UIG has many resources and partners with carriers who can put you in the right place at the right time to help this population. Please get in touch with the UIG Brokerage Team to find out about these opportunities.

By: Linda Isbell, Broker Sales Specialist, Licensed Insurance Agent Specializing in Senior Products