Making Sense of Medicare Choices: Is a Special Needs Plan Right for Those You Serve? February 9, 2026 For people with both Medicare and Medicaid coverage, choosing the best plan to receive their benefits can feel overwhelming. There is no “one-size-fits-all” option, and finding the right plan depends on factors such as unique health needs, the doctors they see and how their care is coordinated. One such option is a Dual Eligible Special Needs Plan (D-SNP), a type of Medicare Advantage plan created specifically for those with both Medicare and Medicaid. This guide is intended to help you determine if a D-SNP is right for those you serve. “When people qualify for both Medicare and Medicaid, it’s important to understand they have choices,” said Bruce Butler, CEO of Samaritan Health Plans and InterCommunity Health Network (IHN-CCO). “Our role is to help make sure people understand how these programs work and what options are available to them.” What’s Available? In Linn, Benton and Lincoln counties, those with Medicare and Medicaid have several plan options available to them, including: Original Medicare Medicare Advantage plans offered by different insurance companies D-SNP Each of these options has different rules, provider networks and ways of coordinating care. D-SNPs recognize that Medicaid helps cover certain costs and services and may offer additional support to help coordinate care between Medicare and Medicaid. “Coordination isn’t just about coverage. It’s about helping people navigate their appointments, benefits and services in a way that makes sense for their lives,” Butler said. Some D-SNPs are offered as Health Maintenance Organization (HMO) plans. This means members generally receive care from doctors and hospitals in the plan’s network, except when there is an emergency or urgent medical issue. Is D-SNP A Good Fit? Locally, Samaritan Health Services does offer a Medicare Advantage HMO D-SNP for people who have Medicare and Medicaid. The plan is designed to serve people who live in our communities and receive care locally. Because it is an HMO, members generally receive care from doctors, clinics and hospitals in the plan’s network, so it is important to check whether a member’s current providers participate before enrolling. A D-SNP may be a good fit if the member: Wants help coordinating care and benefits. Sees doctors or uses hospitals that participate in the network. Prefer having one plan help manage how Medicare and Medicaid work together. Have ongoing or complex health issues and need extra support navigating care. How Does Medicaid Fit Into the Picture? Medicaid coverage in Linn, Benton and Lincoln counties is administered through IHN-CCO. If a member is enrolled and becomes eligible for Medicare, their Medicaid benefits will continue as long as they remain eligible. Other questions that may be helpful to ask include: Are the member’s doctors and hospitals in the plan’s network? How does this plan help them coordinate Medicare and Medicaid? How much help do they need managing care and benefits? If their needs change, how easy is it to change plans? “We encourage people to think about what matters most to them, whether that’s keeping their current doctors, getting extra help coordinating care or having flexibility as their needs change,” Butler said. “Asking the right questions upfront can help people feel more confident in their decisions and avoid surprises later on.”
