The rules for Dual-Eligible Special Needs Plans (D-SNPs) are changing in 2025, and that means a big shift in how agents enroll and support clients.

The good news? These changes create new opportunities to help more people while growing your business – if you have the right strategy.

This week, our VP of Sales Henry Figueroa hosted a webinar with National Broker Sales Director, Rebecca Palazzo (Elevance Health), and National Growth Manager, Michael Volpe (UnitedHealthcare), covering how to create a successful D-SNP strategy.

Missed the webinar? Check out the recording and key takeaways below.

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What’s changing with D-SNPs in 2025?

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The 2025 D-SNP changes are designed to enhance integration between Medicaid and Medicare services, ensuring beneficiaries have more streamlined access to the care they need.

1. No more quarterly Special Enrollment Periods (SEPs). Full duals, partial duals, and LIS enrollees can’t switch plans every three months anymore.
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2. New monthly INT-SEPs. If a full benefit, dual-eligible beneficiary is currently enrolled in (or in the process of enrolling in) the MAO’s affiliated Medicaid Managed Care Program, they are able to enroll into the following types of plans on a monthly basis:
   -- Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP)
   -- Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP)
   -- Applicable Integrated Plan (AIP)
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3. New monthly DEP-SEPs. Dual-eligible beneficiaries with Extra Help / Low Income Subsidies (LIS) can:
   -- Enroll into (or change) a standalone PDP plan;
   -- Leave an MAPD plan and return to Original Medicare, with or without a PDP.
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How to build a strong D-SNP strategy

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Our VP of Sales Henry Figueroa shared this framework for what a comprehensive D-SNP strategy looks like:
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Michael and Rebecca offered practical tips for optimizing your strategy:  

Understand your market

Success in the D-SNP space starts with knowing your market. Identify which carriers dominate your area, which benefits attract the most interest, and where the highest concentrations of dual-eligible individuals live. Policy changes can impact plan availability and eligibility, so staying informed will help you anticipate shifts and adjust your approach accordingly.

Build key partnerships

One of the best ways to reach D-SNP beneficiaries is by partnering with trusted organizations in your community. Building relationships with community health clinics, food banks, nonprofits focused on aging populations, Medicaid offices, and faith-based organizations can provide valuable referrals and position you as a knowledgeable resource. When these groups trust you, they’ll connect you with the people who need your help the most.

Simplify enrollment

Many dual-eligible individuals face barriers to enrollment due to complex paperwork, confusion about eligibility, or skepticism about Medicare Advantage. Make the process easier by offering clear, jargon-free explanations of benefits, guiding clients through Medicaid redetermination, and providing hands-on support. Instead of handing out brochures, take the time to walk clients through their options and ensure they understand how their plan works. 

Pro tip from Rebecca: Add your contact information in your client’s phone along with your picture. “It might be silly to sit there and take a picture of yourself, but when you're calling and they see your picture, your name, insurance help, they'll [think], ‘Oh, I know that person. It's not a spam call. Let me answer.’” 

Support clients after enrollment

Enrolling a client is just the beginning. The real key to retention is staying engaged and helping them navigate their benefits. Regular check-ins at 30, 60, and 90 days can prevent confusion and ensure clients are satisfied with their plan. Ask if they’ve received their insurance card, if they know how to find a doctor, and if they need help scheduling an appointment or using their transportation benefits. When clients feel supported, they’re more likely to keep their coverage, refer others, and rely on you as a trusted advisor.

Use technology to stay efficient

Leveraging technology can make a big difference in managing your workflow and providing a better experience for your clients. A good system helps track client interactions and follow-ups, while automated reminders ensure that clients don’t miss Medicaid recertification deadlines. Digital appointment scheduling makes it easier for clients to meet with you and keeps your schedule organized.

Stay compliant and up to date

With frequent regulatory changes, compliance is critical. Stay informed about CMS guidelines and state-specific Medicaid rules, document enrollments thoroughly, and keep your certifications and training up to date. In some states, like Virginia, Medicaid will auto-align with the selected D-SNP carrier starting in 2025. Brokers in Virginia must also complete DMAS training to get paid, so staying on top of each state’s unique rules is essential.

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What’s next for D-SNPs?

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CMS is making big moves to streamline D-SNPs and integrate them more closely with Medicaid. In the near future, D-SNPs will only be able to enroll members who are in – or enrolling in – their affiliated Medicaid Managed Care Organization (MCO). Medicare Advantage organizations with an affiliated MCO will be limited to one D-SNP plan per service area. These changes point toward greater coordination, fewer plan choices, and a stronger push toward fully integrated care.

Spark agents: Lean on us for support

With so many changes on the horizon, keeping up with compliance, marketing, and strategy can be overwhelming. As always, Spark is here to help. For guidance, reach out to our team at compliance@sparkadvisors.com.

By staying informed, proactive, and engaged with your clients, you can turn these changes into real growth opportunities. 

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Let’s make 2025 your best year yet!