Prepare for D-SNP alignment

Soon, states will implement requirements that may require some Dual Special Needs Plan (D-SNP) members to have their Medicare and Medicaid coverage with the same health plan.

How this change impacts your practice

D-SNP alignment is more than a coverage change. It may also affect patient retention, network participation and day-to-day administrative processes. Preparing now can help your practice navigate upcoming transitions while continuing to deliver coordinated care.

There are benefits for both members and health care professionals when Medicare and Medicaid coverage are aligned under the same health plan. For you, that can mean:

• Simplified billing and claims management: Work with a single health plan for both benefit plans
• More efficient authorization processes: Reduce the need to manage requirements across multiple payers
• Fewer eligibility and coordination-of-benefits issues: Help minimize claim rework and payment delays
• Improved care coordination: Manage patient benefits through just one health plan
• Reduced delays in care: Help patients access needed services more quickly when coverage and authorization processes are aligned

How to prepare

Taking the following steps can help minimize disruptions and support continuity of care for your patients:

• Identify D-SNP members
• Confirm you participate in both Medicare and Medicaid plans
• Re-check eligibility for upcoming visits
• Prepare front-office staff to answer member questions about coverage changes

Additional D-SNP details are available in our guide.

Check your network status

Before alignment requirements take effect, review your participation status using My Practice Profile in the UnitedHealthcare Provider Portal. For step-by-step instructions, see the My Practice Profile interactive guide.