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D-SNP
Integrated Care for Dual Eligible Members
One care team across both coverages — aligning benefits, providers, and authorizations so dual-eligible members stop navigating two separate systems on their own.
How it works
California's dual-eligible members deserve one care experience — not two systems to navigate.
01
Benefit Alignment
Confirming Medicare and Medi-Cal coverage is coordinated, with Medi-Cal paying for Medicare cost-sharing where members qualify.
02
Integrated Care Planning
A single care plan that spans primary care, specialty care, behavioral health, pharmacy, and long-term services and supports.
03
Care Coordination
One team owns scheduling, referrals, prior authorizations, and follow-up across both Medicare and Medi-Cal networks.
04
Long-Term Services & Supports
In-home supportive services, community-based adult services, and nursing-facility diversion coordinated through the care plan.
05
Behavioral Health Integration
Mental health and substance use treatment embedded in the care plan instead of carved out as a separate referral.
06
Transitions of Care
Hospital, ER, and SNF discharges with medication reconciliation, follow-up visits, and home support arranged in advance.
07
Caregiver Support
Education, respite, and navigation for family caregivers who carry much of the day-to-day load for dual-eligible members.
Proven results
The challenge — and the impact
Statewide data from the California Department of Health Care Services (DHCS), Medi-Cal, and CalAIM.
1.5M+
Californians enrolled in both Medicare and Medi-Cal
Source · California DHCS
ReadStatewide
CalAIM is aligning Medi-Cal with Medicare D-SNPs across California
Source · California DHCS CalAIM
Read~2x
Hospitalization risk for unmanaged dual-eligible members vs. integrated care
Source · MedPAC / CMS
ReadHow we overcome it
What Atlas Health Group does about it
Each challenge above is paired with the concrete way our care model addresses it on the ground.
01
One care team across both coverages
Dual-eligible members get a single team that owns Medicare and Medi-Cal coordination — instead of being told to call the other plan.
02
Aligned with CalAIM and D-SNPs
Our integrated care work plugs directly into California's D-SNP alignment strategy, partnering with Medi-Cal MCPs and Medicare plans.
03
Built to reduce avoidable utilization
Proactive transitions, aligned medications, and a real point of accountability — the combination MedPAC has shown reduces hospitalization risk.
Who it's for
Does any of this sound like you or someone you know?
Integrated Care for Dual Eligible Members is designed for the situations below. If even one fits you or someone you love, you likely qualify at no cost through your Medi-Cal plan.
01
Adults enrolled in both Medicare and Medi-Cal
02
Members in a Dual Special Needs Plan (D-SNP)
03
Older adults managing multiple chronic conditions
04
Members in or transitioning from skilled nursing facilities
05
Adults with disabilities needing long-term services and supports
06
Family caregivers supporting a dual-eligible loved one
07
Members confused by overlapping Medicare and Medi-Cal benefits
08
Dual-eligible members at risk of avoidable hospitalization
What's included
Benefits
Tangible support you can count on from day one — fully covered by your Medi-Cal plan.
One care team across Medicare & Medi-Cal
A single, integrated team coordinates benefits, providers, and authorizations across both programs — no more being bounced between plans.
Aligned benefits & cost-sharing help
We make sure Medi-Cal picks up Medicare premiums, copays, and deductibles you're entitled to — eliminating out-of-pocket surprises.
Prescription & specialty coordination
Medicare Part D and Medi-Cal pharmacy benefits are coordinated together, with refills, prior auths, and specialty referrals handled by your care team.
Long-term services & supports
Connections to in-home support, caregiver respite, adult day services, and skilled nursing alternatives — keeping you safe at home.
Behavioral health & complex care
Integrated mental health, substance use, and complex chronic disease management — built into one plan rather than three referrals.
Transitions across settings
Hospital, SNF, and home transitions managed end-to-end so dual-eligible members don't fall between Medicare and Medi-Cal coverage at the worst moments.
Ready to get started?
Become a member online in minutes, or call us and a specialist will walk you through it — at no cost when covered by Medi-Cal.