Dual-Eligible OTC Benefits: Extra Allowance for Medicare-Medicaid Members
What Does Dual-Eligible Mean?
Dual-eligible members qualify for both Medicare and Medicaid. If you have both, you're likely enrolled in a Dual Special Needs Plan (D-SNP) that offers significantly enhanced OTC benefits.
Enhanced OTC Benefits for Dual-Eligible Members
- Higher allowances: D-SNP plans often offer $100-$300+ per quarter (vs. $25-100 for standard MA)
- More covered products: Many D-SNP plans include healthy foods, personal care items, and household products
- Additional benefits: Transportation to appointments, home-delivered meals, pest control
Top D-SNP Plans by OTC Allowance
- UnitedHealthcare Dual Complete: Up to $200/quarter OTC + healthy foods
- Humana Gold Plus D-SNP: Up to $150/quarter OTC
- Anthem Dual Advantage: Up to $175/quarter OTC + utilities assistance
- Molina Dual Options: Up to $125/quarter OTC
Are you dual-eligible? If you receive Medicaid benefits (food stamps, Medicaid card) AND have Medicare, you likely qualify for a D-SNP with enhanced OTC benefits. Contact your state Medicaid office to confirm.
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