Key Steps and Considerations for States Using “Medicare-First” Exclusively Aligned Enrollment Processes with Dual Eligible Special Needs Plans (D-SNPs)
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Associated Project
Supporting States in Improving Care for Dually Eligible Individuals through the Integrated Care Resource Center
Prepared for:
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Medicare - Medicaid Coordination Office
This technical assistance brief outlines key steps and considerations for states implementing exclusively aligned enrollment using a "Medicare-first" approach (meaning the state matches a dually eligible individual's Medicaid enrollment to their dual eligible special needs plan (D-SNP) enrollment). The brief provides: 1) an overview of the MA enrollment process; (2) a summary of key steps in aligning Medicaid coverage with D-SNP enrollment; 3) key decisions for states interested in using Medicare-first EAE; 4) examples of common enrollment and disenrollment scenarios for states to consider when designing Medicare-first EAE processes; and 5) descriptions of the files through which states can learn about D-SNP enrollments and disenrollments.
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