Dual Coverage: Traditional Medicare / Medicaid vs. D-SNP Plans

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Dual Coverage: Traditional Medicare / Medicaid vs. D-SNP Plans

** June 2026 Update: As of June 2026, the Washington Health Care Administration (HCA) shared that Dual-Eligible Special Needs Plans (DSNP) will now be referred to as Apple Health Medicare Connect plans in Washington State.** 

Navigating medical benefit coverage can be confusing—even identifying what type of medical benefit someone is enrolled in can be a challenge at times. In Washington State, individuals who qualify for both Medicare and Medicare have two main options: they can stick with Traditional Medicare, which includes Parts A, B, and optionally D, or they can choose to enroll in a Medicare Advantage plan, specifically a Dual-Eligible Special Needs Plan (D-SNP) if they also qualify for Medicaid.

While both paths offer access to essential healthcare services, the coverage, benefits, and even the insurance cards can look very different. For benefit planners, caregivers, and individuals trying to understand their coverage, it’s not always easy to tell which plan is in place. The chart below gives an overview of some of the key differences to consider when trying to identify which Medicare option may work best for you.

Please know that BenefitU is not able to support individuals with managing the specific details of their Medicare plan. We hope that the information below provides an overview of the differences between these options as well as resources if additional support is needed.

FeatureTraditional Medicare and Medicaid CoverageD-SNP (Dual-Eligible Special Needs Plan)
EligibilityMedicare (age/disability)

Medicaid (income-based or buy-in option)
Must qualify for both Medicare and Medicaid
CoverageMedicare Part A (Hospital) & B (Office Visits)

Medicaid offers both healthcare and a variety of services for qualified beneficiaries
Medicare Part C / Advantage Plan with integrated Medicaid benefits.

Part C coverage will vary based on plan
Prescription DrugsPart D plan is included when enrolled in traditional Medicaid + Medicare

Beneficiaries are automatically enrolled in a Part D plan but may also select a different plan depending on their needs.
Part D coverage is often included as part of most D-SNPs.
Extra BenefitsLimited or noneDental, vision, hearing, transportation, OTC, meals may be included depending on D-SNP plan selected.
Care CoordinationSeparate systems for Medicare and MedicaidCoordinated care between Medicare and Medicaid programs.
EnrollmentThrough Social Security or state Medicaid office; www.Medicare.govVia approved D-SNP providers during enrollment periods; www.Medicare.gov
Plan CardMedicare and Medicaid cards

Note: In Washington State, Medicaid is also known as Apple Health / Provider One.
D-SNP provider card:
Community Health Plan of Washington, Humana, Molina, United Healthcare, Wellcare, Wellpoint The above may be in addition to a standard Medicare card.
Support and Additional InformationMedicaid (Website)

Medicare (Website)
D-SNP provider website

SHIBA (WA)

Apple Health Medicare Connect

Medicare (website)

Whether a person chooses to enroll in a Medicare Part-C D-SNP plan or traditional coverage should be based on individual need. Researching what plans meet your needs before enrolling is always encouraged.

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