Dual Eligible Special Needs Plans in Perth Amboy, NJ
Coordinated coverage for residents with both Medicare and Medicaid
Click to CallThis is a private website. By requesting information, you will be contacted by a licensed insurance agent. We are not a government agency.
Medicare and NJ FamilyCare, Working Together
Some Perth Amboy residents qualify for both Medicare and NJ FamilyCare, New Jersey's Medicaid program. They are known as dual eligible, and they have access to a special type of Medicare Advantage plan called a Dual Eligible Special Needs Plan, or D-SNP.
A D-SNP is designed to coordinate both sets of benefits so that doctors, hospitals, prescriptions and extra services work together instead of sending you separate bills and separate rules.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Who Counts as Dual Eligible
You are dual eligible if you have Medicare and also qualify for full NJ FamilyCare benefits or for one of the Medicare Savings Programs, which help pay Medicare premiums and cost sharing.
Eligibility depends on income and resources. Many people do not realize they qualify, especially after a spouse passes away or income drops in retirement. Our page on paying less for Medicare explains how the savings programs work.
What a D-SNP Typically Adds
- Low or no cost sharing for many medical services, depending on your Medicaid level
- Prescription coverage built into the plan
- Care coordination, with a team that helps arrange appointments and services
- Extra benefits that many plans include, such as dental, vision, hearing or an allowance for health items
New Jersey also offers integrated plans that bring Medicare and NJ FamilyCare benefits, including managed long-term services and supports, under one company. We explain which type you are looking at and what it means for your care.
Checking Your Doctors and Care Team
A D-SNP is still a network plan. Before you enroll, we check whether your primary doctor, specialists and Raritan Bay Medical Center or other hospitals you use are in the network. If you receive home care, adult day services or help from an aide, we look at how those services are handled under the plan.
We also check that your pharmacy is in the network, since prescription coverage moves into the plan.
When You Can Make a Change
People with both Medicare and Medicaid have more chances to change plans than most Medicare members. The rules for these special periods were updated recently, and they depend on the type of plan you choose. We review the current options with you before any move, so you do not lose benefits by accident.
Keeping Your Medicaid Active
D-SNP enrollment depends on keeping your NJ FamilyCare eligibility. Medicaid requires a periodic renewal, and missing the paperwork can affect your plan. Keep an eye on mail from the state and from the Middlesex County Board of Social Services, and ask a relative or the Office on Aging for help if forms are confusing.
Sit Down With Us Over the Phone, Free
Have your pill bottles or medicine list close by. We hold what you carry now against the plans we represent and translate the gap into dollars and doctor access. Most calls wrap up in roughly half an hour, nothing gets signed on the spot, and you can get to know our agency beforehand.
Click to CallD-SNP: What Perth Amboy Neighbors Ask
Do I lose my Medicaid if I join a D-SNP?
No. You keep NJ FamilyCare; the plan is designed to work with it. You need to stay eligible for Medicaid to keep the plan.
Are there costs to me?
Many members pay little or nothing, depending on their Medicaid level, but it varies by plan and by your situation.
Can a family member speak for me?
With your permission, yes. We are glad to include a caregiver or relative in the conversation.
Every dollar amount on this page follows 2026 federal rules. We rechecked the details on October 30, 2026.
Where to Go Next
Help Paying for Medicare
State and federal relief such as PAAD, Senior Gold and Extra Help.
Medicare Advantage
Private Part C coverage weighed against the doctors and refills you already rely on.
Part D Drug Plans
Stand-alone prescription coverage priced against your real medicine list.