A person who has both NJ FamilyCare/Medicaid and Medicare is referred to as a "dual eligible." Most individuals with intellectual and developmental disabilities (IDD) who are dual eligibles received Medicaid first, and at a later time, they started to receive Medicare also. But occasionally, some individuals with IDD may have Medicare first, and Medicaid starts later.
The New Jersey Department of Human Services, Division of Aging Services, State Health Insurance Assistance Program (SHIP) has published the 2024 Medicare Part D Stand-Alone Prescription Drug Plans (PDPs) in NJ.
Enrollment in a Medicare Part D drug plan is mandatory for dual eligibles, unless the individual has creditable drug coverage from a private health insurance plan that is as good or better than Medicare Part D.
11/13/23 Update for 2024 on the Medicare Drug Benefit for People Who Have Both Medicare and Medicaid (the Dual Eligibles)
11/03/22 Update for 2023 on the Medicare Drug Benefit for People Who Have Both Medicare and Medicaid (the Dual Eligibles)
It has come to our attention that there may be some confusion regarding the voluntary nature of D-SNP enrollment. Therefore, it is important for families and staff to understand that enrollment into a D-SNP continues to be voluntary and is not required. If anyone informs you that a D-SNP enrollment is required, please email Connor Griffin at The Arc of New Jersey (firstname.lastname@example.org) so that we can facilitate the correction of the misinformation.
The Arc of New Jersey's D-SNP FAQs were updated because of a change that became effective on January 1, 2019, authorized by the federal Centers for Medicare and Medicaid Services (CMS). This change pertains to the process to be followed if a dual eligible who has enrolled in a D-SNP wants to disenroll. See below for The Arc of New Jersey's revised D-SNP FAQs.
Frequently Asked Questions (FAQs) for Dual Eligibles
The Arc of New Jersey's Health Care Advocacy program is distributing information in the form of Frequently Asked Questions (FAQs) fact sheets to respond to the questions that families have been asking: