Medicare Dual Special Needs Plan (D-SNP)
In alignment with the requirements of CalAIM and reflecting CenCal Health’s Strategic Priorities, we will be offering a Medicare Advantage Dual Special Needs Plan beginning in January 2026.
Members with Medicare and Medi-Cal already receive Medi-Cal covered services through CenCal Health and are often referred as “Dually Eligible Beneficiaries,” “Duals,” or “Medi-Medi’s.”
Today, CenCal Health covers nearly 23,000 duals by providing the Medi-Cal portion of their benefits.
- Santa Barbara County: Approximately 15,000
- San Luis Obispo County: Approximately 8,000
D-SNPs are purpose-built to address the intricate healthcare needs of individuals dually eligible for Medicare and Medicaid (Medi-Cal in California). CenCal Health’s D-SNP will be an exclusively aligned enrollment model, meaning only those residents receiving Medi-Cal through CenCal Health and also eligible for Medicare can select our D-SNP.
By offering an exclusively aligned D-SNP, we can elevate our ability to deliver integrated care, tailoring additional benefits to meet the diverse and unique circumstances of our members. D-SNPs consolidate Medicare and Medi-Cal benefits under one comprehensive umbrella, ensuring streamlined access to care and providing members with additional benefits beyond what’s typically available in traditional Medicare Fee-For-Service plans.
What is a Medicare Dual Special Needs Plan (D-SNP)? A Medicare Advantage Dual Special Needs Plan (D-SNP) is a plan that integrates care for people who have both Medicare and Medi-Cal.
When a beneficiary enrolls in a Medicare D-SNP, they are covered for their Medicare and Medi-Cal benefits by one plan. Members receive additional benefits not available in Medicare Fee-For-Service or Medi-Cal.
For any inquiries or to schedule a meeting, please contact (805) 562-1059 or email DSNP@cencalhealth.org
What do you need to know as a current or potential CenCal Health provider?
Here is why you want to join us:
Benefits to Providers:
- The members that will be served through the DSNP line of business are current CenCal Health members, which means that as a provider you are having to work with two plans. By contracting with CenCal Health as a DSNP provider, you will only need to work with us!
- One health plan point of contact for your practice
- For most claims, benefits will all be coordinated in-house by CenCal Health
- Enhanced care coordination and interdisciplinary care teams
- Access to CenCal Health’s local resources
- D-SNP Provider Resource
Benefits to Members:
- Fully integrated services through one health plan
- Enhanced Care Coordination
- Seamless patient experience with one point of contact for all of their healthcare needs
Provider Training & Engagement Resources
We’re thrilled to welcome you as a valued partner in the launch of CenCal CareConnect (D-SNP), an exciting new Medicare Advantage plan designed for individuals eligible for both Medicare and Medi-Cal. Launching January 1, 2026, this program represents a shared commitment to delivering high-quality, coordinated care to a population with unique needs of our dual-eligible members.
As we prepare for this important milestone, we are proud to introduce our CenCal CareConnect D-SNP Provider Training Program, a thoughtfully designed series of educational opportunities to support you every step of the way.
Essential Training Courses:
- Medicare Dual Special Needs Plan: An Introduction (Training Recording)
- Understanding D-SNPs: A Guide for Providers
- Coordination of Benefits for CareConnect Members
- Claims & Billing and Risk Adjustment
- Care Coordination & Case Management
- Medicare Compliance in D-SNP Members
- Transitions of Care
- Maximizing Clinical Quality Care Incentive Program & STARs Introduction
- STARs Program Overview
Model of Care Training – Annual required training course for all participating physicians
CenCal Health’s CareConnect (D-SNP) Model of Care (MOC) training provides an overview of how CenCal Health coordinates care for members who are eligible for both Medicare and Medi-Cal. This training outlines the key elements of our care model, including member-centered care management, interdisciplinary care teams, and provider collaboration to improve health outcomes. All participating contracted providers and their physicians are required to complete this training annually and submit an attestation confirming their participation, as part of CMS compliance requirements.
Provider Resources
- Virtual D-SNP Provider Town Hall Meeting Questions
- Virtual D-SNP Community Partner Town Hall Meeting Questions
- DHCS Medi-Medi Plan Webpage
- DHCS Integrated Care for Dual Eligible Beneficiaries Website
- DHCS D-SNPs in California Website
- CenCal Health D-SNP Journey Map
Together, we are building a strong foundation for the success of the CenCal CareConnect D-SNP and the health of our members. Your dedication, insight, and collaboration make all the difference.