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 & 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 a 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 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 with the Provider Relations department, please reach out to us at provideronboarding@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
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 Engagement & Resources
Join us! CenCal Health looks forward to engaging providers in the development of our D-SNP. Learning more and becoming contracted is easy.
To request more information or a meeting please email provideronboarding@cencalhealth.org.
Provider Engagement
Medicare Dual Special Needs Plan: An Introduction (Meeting Recording & Presentation Slides)
CenCal Health held an Informational Session on the development of a Medicare Dual Special Needs Plan (D-SNP) to be offered in 2026. In addition, The Department of Health Care Services’ (DHCS) collaborated as a guest speaker and highlighted Medicare Medi-Cal Plans (Medi-Medi Plans) in San Luis Obispo and Santa Barbara Counties and a 2026 Look-Ahead for Providers.