Medicare
Medicare and Medicaid Dual Eligible Plans
If you qualify for both programs, you are likely leaving benefits on the table.
People who have Medicare and also qualify for Medicaid are called dual eligible. In Tennessee, Medicaid is administered as TennCare, and dual eligible residents can enroll in Dual Special Needs Plans (D-SNPs) built specifically for them.
These plans typically carry a $0 premium, minimal or no copays, integrated prescription coverage, transportation to appointments, dental and vision benefits, and a monthly allowance for over-the-counter items. Many dual eligible residents in Middle Tennessee stay in a standard plan for years simply because nobody told them a better option existed.
Problems we hear every week
Two programs that don't talk to each other
Beneficiaries get letters from both Medicare and TennCare and cannot tell which pays for what.
Paying costs that should be covered
Qualified Medicare Beneficiary status can eliminate premiums and cost sharing, yet people keep paying them.
Missing the extra benefits
Transportation, dental, OTC allowances and care coordination go unused because they were never explained.
How we solve it
Eligibility screening
We check your income and asset situation against TennCare and Medicare Savings Program levels — with no obligation.
D-SNP comparison
We compare every dual eligible plan available in your county and their benefit allowances side by side.
Ongoing advocacy
When redetermination letters arrive or benefits stop unexpectedly, you call us and we help sort it out.
Ready to see your options?
A review takes about twenty minutes, costs nothing, and ends with real numbers instead of a sales pitch.
What you gain
- $0 or near-$0 premiums and cost sharing
- Prescription costs reduced through Extra Help
- Rides to medical appointments and pharmacy pickups
- The ability to change plans more often than other beneficiaries
Serving Nashville and Middle Tennessee
We help dual eligible clients throughout Nashville and Middle Tennessee, plus surrounding communities in Gallatin, Smithville, Woodbury, Portland, Doyle and Carthage. Rural transportation benefits matter a great deal here, and they vary noticeably between plans.
FAQ
Medicare Medicaid questions we answer often
How do I know if I qualify for TennCare?+
Eligibility depends on income, household size and category. We do a quick screening and point you to the right application if it looks promising.
Will a D-SNP change my doctors?+
Possibly. We confirm your providers are in-network before you enroll, and if they aren't, we look at other options.
Do I lose TennCare if I take a Medicare plan?+
No. A dual eligible plan is designed to coordinate the two programs, not replace either one.
How often can dual eligible members change plans?+
Because of recent changes made by the Centers for Medicare and Medicaid Services, dual plans can only be changed during the Annual Open Enrollment and Medicare Advantage Open Enrollment periods.
Get a free Medicare Medicaid review
We will compare your options, explain the trade-offs in plain language, and handle the paperwork. Serving Nashville, Middle Tennessee and our entire state.