Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 3/5
A beneficiary who qualifies for both Medicare and Medicaid (dual eligible) is considering a Medicare Advantage plan that coordinates Medicare and Medicaid benefits and may include a share of cost. Which plan type fits this description?
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Answer & full 3-part explanation (select an option above, or peek)
Why C is correct
A Dual-Eligible Special Needs Plan (D-SNP) is a Medicare Advantage plan designed for beneficiaries entitled to both Medicare and Medicaid, who are known as dual eligibles. The plan coordinates Medicare and Medicaid benefits, often paying for items such as deductibles, copayments, and premiums on the member's behalf, and it may include a share-of-cost arrangement for certain services. D-SNPs are one of the three categories of Special Needs Plans under Part C.
Why the other options are wrong
- A) A stand-alone PDP provides only prescription drug coverage and does not coordinate Medicare and Medicaid medical benefits.
- B) Medigap cannot be used by Medicare Advantage enrollees and does not coordinate with Medicaid.
- D) An employer group waiver plan is an employer-based Medicare arrangement, not a dual-eligible coordination plan.
Memory hook
Dual eligible = Medicare plus Medicaid = D-SNP. The plan knits the two programs' benefits together.