What Does "Dual Eligible" Mean?

Dual eligible means you qualify for both Medicare (federal) and Medicaid (state). This can happen when you're 65+ with limited income, or under 65 with a qualifying disability and low income.

Dual-eligible beneficiaries often receive significantly more benefits than those on Medicare alone — including help paying premiums, deductibles, copays, and additional services like transportation, dental, and over-the-counter health products.

What Is a DSNP?

A Dual Special Needs Plan (D-SNP) is a type of Medicare Advantage plan designed specifically for people who have both Medicare and Medicaid. These plans coordinate benefits from both programs and often include:

  • $0 premium (in addition to any Part B premium)
  • $0 copays for many services
  • Prescription drug coverage with low or no copays
  • Dental, vision, and hearing benefits
  • Transportation to medical appointments
  • Over-the-counter (OTC) allowances — quarterly stipend for health products
  • Meals after hospital stays

💡 Extra Help / Low-Income Subsidy (LIS)

If you have Medicare and limited income, you may qualify for Extra Help — a federal program that helps pay Part D premiums, deductibles, and copays for prescription drugs. Many dual-eligible individuals automatically qualify.

Who Qualifies?

You may be dual eligible if you:

  • Are 65+ or have a qualifying disability AND
  • Have limited income (varies by state — in Florida, generally under $1,600/month for individuals)
  • Have limited resources (savings, investments — typically under $9,430 for individuals)

Eligibility for Medicaid is determined by your state. In Florida, you apply through the Department of Children and Families (DCF).

How We Help

  • Determine if you may qualify for dual-eligible benefits
  • Compare available DSNP plans in your area
  • Help you understand what's covered and coordinate both programs
  • Connect you with Medicaid enrollment resources if needed

Our guidance is completely free — call us to see what benefits you may be missing.

Frequently Asked Questions

Yes. About 12 million Americans are "dual eligible" — enrolled in both programs simultaneously. If you qualify, you may receive additional benefits and lower costs through both programs working together.

DSNPs are Medicare Advantage plans specifically designed for dual-eligible individuals. They coordinate Medicare and Medicaid benefits, often include extra perks (transportation, OTC allowances, meals), and typically have $0 premiums and very low or no copays.

In Florida, you apply for Medicaid through the Department of Children and Families (DCF) at myflfamilies.com or by calling 1-866-762-2237. We can help point you in the right direction.

No. Medicare and Medicaid are separate programs. Having Medicaid doesn't replace Medicare — it supplements it by helping cover costs that Medicare doesn't, like copays and premiums.