When you’re eligible for Medicare and also have Medicaid benefits, it can be hard to understand how to get the most out of your coverage. UnitedHealthcare is here to help you now and as your needs change.
2025 D-SNP enrollment period frequently asked questions
As of January 1, 2025, there are new rules for Medicare that may affect when you can sign up for or change your Dual Special Needs Plan (D-SNP). When you’re eligible for Medicare and also have full Medicaid benefits, it can be hard to understand how to get the most out of your coverage. From choosing a plan to using your plan, you can count on UnitedHealthcare to help guide you every step of the way.
What are the big enrollment changes for Dual Special Needs Plans (D-SNPs) in 2025?
As of January 1, 2025, the quarterly SEP that previously allowed individuals who had both Medicare and Medicaid to enroll in or make changes to their Medicare Advantage plan once per quarter, is no longer available. If you’re eligible for Medicare and have Medicaid benefits, there will be a new monthly Special Enrollment Period (SEP) for enrolling in certain integrated Dual Special Needs Plans instead of the quarterly one you may be used to.
How does the new Special Enrollment Period impact members who receive Medicare and full Medicaid benefits?
While the quarterly SEP ended as of January 1, 2025, the new integrated care SEP now allows individuals who are eligible for both Medicare and full Medicaid benefits to enroll in a Dual Special Needs Plan (D-SNP) that brings Medicare and Medicaid under one insurer.
Why are these changes happening?
These changes are a result of new federal Medicare regulations. These new policies outline changes to Medicare Advantage (MA) and Medicare Part D programs for all insurers over the next five years. Among other goals, these new regulations are working to coordinate Medicare and Medicaid programs to make the dual eligible experience more connected, accessible and affordable.
Why might it be helpful having Medicare and Medicaid coverage under the same insurer?
Bringing together your Medicare and Medicaid coverage under one insurer may help you:
- Feel like you’re managing one health plan instead of two
- Integrate benefits that were separate before, like physical therapy (Medicare) during home health (Medicaid)
- Manage different health systems and doctors
I'm a UnitedHealthcare member. Who can I reach out to for questions about my Medicaid and/or Medicare coverage?
We encourage you to discuss your options with a member of our Customer Service team by calling the number on the back of your UnitedHealthcare UCard® or member ID.
I'm not a UnitedHealthcare member, but can you help?
While we encourage you to discuss your options with your current insurer or agent, we're here to help. Find a UnitedHealthcare D-SNP available in your area.
Other things to know about the new Integrated care Special Enrollment Period (SEP) and eligibility
The new integrated care Special Enrollment Period (SEP) is only available to those who are eligible for Medicare and have full Medicaid benefits.
The integrated care SEP can be used once per month, including during the Annual Enrollment Period (AEP) between October 7 and December 15 and Medicare Advantage Open Enrollment Period from January 1 to March 31.
The new integrated Special Enrollment Period may be used to enroll in select plan types, including:
- D-SNPs that are Applicable Integrated Plans (AIPs)
- Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs)
- Highly Integrated Dual Eligible Special Needs Plans (HIDE SNPs)
- While UnitedHealthcare HIDE SNPs are eligible, this may not be the case with all insurers
The options for this enrollment period depend on the plans available where you live and which insurer you use, so it's recommended to speak directly with your insurer or agent for more information. If you are a UnitedHealthcare Medicare member and have more questions, we encourage you to discuss your options with a member of our Customer Service team by calling the number on the back of your UnitedHealthcare UCard® or member ID.
With the integrated care SEP, members with Medicare and full Medicaid benefits can make a change once per month into a qualifying plan. Any changes will take effect the first of the following month. In addition to this monthly enrollment period, you will still be able to enroll or make changes to your plan during other enrollment periods, such as the Medicare Annual Enrollment Period (AEP), Medicare Advantage Open Enrollment Period (MA OEP) or if you experience a qualifying life event.
Some big events in your life can trigger a Special Enrollment Period for making changes to your Medicare coverage. These include:
- You recently had a change in, or are no longer eligible for, Extra Help paying for Medicare prescription drug coverage or Medicaid
- Being eligible for Medicare before you're 65, and now you're turning 65
- Losing coverage from your employer
- Moving outside of the service area for your current plan or into the service area of a new plan
- Moving in or out of a long-term care facility, such as a nursing home
- Enrolled in a plan by Medicare (or the state) and want to choose a different plan within 3 months
- Delayed enrollment into Medicare Part B (outpatient and medical coverage), and now you have Part B
- Recently enrolled in a Medicare Advantage plan for the first time and want to make a change during the first 3 months of enrollment
Each year, the Annual Enrollment Period (AEP) runs from October 15 – December 7 and the Medicare Advantage Open Enrollment Period (MA OEP) runs from January 1 – March 31.
From choosing a plan to using your plan, you can count on UnitedHealthcare to help you every step of the way. For more information and resources related to the new integrated SEP, view our D-SNP enrollment changes article.
Share
About Medicare Made Clear
Medicare Made Clear brought to you by UnitedHealthcare provides Medicare education so you can make informed decisions about your health and Medicare coverage.
More articles
More articles
Get the latest
Boost your Medicare know-how with the reliable, up-to-date news and information delivered to your inbox every month.
*All fields required