No, a D-SNP is a Medicare Advantage plan type that limits enrollment to dual-eligible members only. However, it only covers the Medicare and Part D benefits, and not Medicaid benefits. Medicaid benefits are still administered through the State’s Oregon Health Plan program.

Generally, the enrollment process is the same. However, since Providence Medicare Dual Plus (HMO D-SNP) may only enroll full- benefit dual-eligible members, an additional eligibility step is required. Our Membership Accounting team will need to verify Medicaid eligibility status in Oregon’s Medicaid Management Information System (MMIS) prior to enrollment.

Full-benefit eligible dual beneficiaries may enroll and/or switch plans:

• During the annual enrollment period
• Once per quarter for the first 3 quarters of the year
• During special circumstances such as a change in the level of Extra help or Medicaid

A member can join our Providence Medicare Dual Plus (HMO D-SNP) in the same ways that a member can join our other Medicare Advantage plans. For example, an individual can enroll via an agent/broker, a direct paper application, a telephonic application or any other methods we use to enroll Medicare Advantage members. Additionally, their State case worker can assist with enrollment.

No, Providence Medicare Dual Plus (HMO D-SNP) is open to any full-benefit dual-eligible members residing in the tri-county area regardless of coordinated care organization (CCO) or health share physical health plan managing their OHP coverage.

Dual-eligible members are enrolled in limited drug plans through Medicaid. Providence Medicare Dual Plus (HMO D-SNP) includes Medicare Part D and is the primary prescription drug coverage.

Over-the-counter drugs on the OHP formulary only.

Yes, if the YCCO Medicaid recipient lives in Washington County.