Highmark to offer special needs plans for Medicare/Medicaid members

Highmark Health Options, Delaware's largest Medicaid managed care organization announced new coverage options from Highmark Blue Cross Blue Shield that will soon be available.

Beginning Jan. 1, 2025, Highmark BCBS will offer Dual Special Needs Plans (D-SNP) for Delawareans who are eligible for both Medicaid and Medicare health care coverage. Highmark Health Options Duals (HMO SNP) plans are available during the current annual enrollment period, which runs until Dec. 7.

Dual Special Needs Plans are managed care health insurance plans specifically designed for individuals whose health needs require elevated levels of care. Individuals who benefit are often managing chronic conditions such as diabetes, high blood pressure, or mental and behavioral health.

Dual Special Needs Plans help improve care coordination and health outcomes while managing cost.

Dual Special Needs Plans are closely aligned with long-term services and supports care (LTSS). Long-term services and supports includes both clinical and nonclinical care. Those who benefit from this type of care are people born with a disability, who develop a disability, or through the aging process are managing chronic conditions and comorbidities that can make everyday life more challenging. Highmark Health Options Delaware currently serves nearly 6,000 LTSS members.

"Our standing as the state's largest Medicaid and long-term services and supports insurer make us uniquely positioned to assist our neighbors who need more support and attention to manage their health care needs," said Todd Graham, president, Highmark Health Options. "The Dual Special Needs market demands innovative solutions and personalized care. We're committed to bringing our expertise and resources to this space to help address the specific challenges faced by individuals in need of these services."

In addition to the Medicare and Medicaid requirement, highlights of D-SNP include:

Enhanced Benefits – examples include transportation assistance and dental, vision and hearing servicesCare Coordination – can include disease management programs and dedicated case managersCommunity Collaboration – coordination with community organizations in the delivery of benefits

According to a 2021 report by the Medicaid and Children's Health Insurance Program Payment and Access Commission, about 33,000 Delawareans were eligible for D-SNP enrollment at that time.

In light of Delaware's population growth of nearly 3% from 2021 through 2023, the number of eligible individuals is likely to have increased.

Highmark Health Options has more than 124,000 members. Further information is available at www.highmarkhealthoptions.com.