A D-SNP, or Dual Eligible Special Needs Plan, is a Medicare Advantage plan for people with both Medicare and Healthy Connections Medicaid. South Carolina offers two kinds: Highly Integrated D-SNPs, where the same company also manages your Medicaid through an aligned health plan, and Coordination-Only D-SNPs, which work with your existing Medicaid plan. Healthy Connections Prime ended January 1, 2026, and its members were encouraged to switch to a D-SNP. Here is how D-SNPs work in South Carolina and how to choose.
What is a D-SNP in South Carolina?
The South Carolina Department of Health and Human Services describes a Special Needs Plan as a type of Medicare Advantage plan that provides benefits to members who have Medicare and Medicaid. A D-SNP covers your Medicare hospital, medical and drug benefits, and it is required to coordinate with Healthy Connections Medicaid, which SCDHHS runs. On its Dual Special Needs Plans page, SCDHHS explains that the D-SNP serves as your primary Medicare coverage, followed by Healthy Connections Medicaid.
Like every Special Needs Plan, a D-SNP must include Part D prescription drug coverage, so you don't buy a separate drug plan. Most people with Medicaid also get Extra Help, which keeps drug copays low. Many D-SNPs add benefits Original Medicare doesn't cover, such as dental, vision, hearing or transportation, but those vary by plan and change each year. Read the plan's evidence of coverage, not just the advertising, and make sure any extra you are counting on is available in your county.
What are the two types of D-SNPs in South Carolina?
| Feature | Highly Integrated D-SNP (HIDE) | Coordination-Only D-SNP (CO) |
|---|---|---|
| Medicare coverage | Yes | Yes |
| Medicaid management | Through an aligned Medicaid health plan from the same parent company | Your existing Medicaid health plan or Healthy Connections Medicaid |
| Who it enrolls | People with full Medicaid benefits, under the state contract | People with Medicare and Medicaid, including some with partial Medicaid |
| Main advantage | One company coordinating both programs | Keeps your current Medicaid plan in place |
SCDHHS explains that if a Healthy Connections Medicaid member enrolls in a D-SNP to manage their Medicare, they will be enrolled into a Medicaid health plan that aligns where available, so the same parent organization manages both. The state calls this exclusively aligned enrollment, offered by a HIDE D-SNP. Members who choose a HIDE D-SNP may have additional enrollment requirements.
What happened to Healthy Connections Prime?
Healthy Connections Prime was South Carolina's Medicare-Medicaid plan. SCDHHS says on its Healthy Connections Prime page that as of January 1, 2026, Prime has ended. Members who were enrolled in Prime were encouraged to switch to a new D-SNP, and some members may have been moved automatically if their plan offered a D-SNP. If you or a parent were in Prime and aren't sure what coverage you have now, check your current Medicare card from the plan and call the plan or us to confirm.
Former Prime members should check three things now: that the new plan still includes the doctors and specialists they used, that every prescription is on the new plan's drug list, and that any home and community-based services they receive through Medicaid are still coordinated. If something is missing, the monthly change option described below lets you correct course without waiting until next year.
Who qualifies for a D-SNP in South Carolina?
SCDHHS lists the Medicaid groups CMS identifies as potentially eligible for D-SNPs: full Medicaid, Qualified Medicare Beneficiaries with or without other Medicaid, Specified Low-Income Medicare Beneficiaries with or without other Medicaid, Qualifying Individuals, and Qualified Disabled and Working Individuals. The state's contracts with each plan decide which of those groups a given plan can enroll. In general you need:
- Medicare Part A and Part B.
- Healthy Connections Medicaid, full or in a qualifying partial category.
- An address in the plan's service area.
Our page on having Medicare and Medicaid in South Carolina explains the categories, and our page on help paying for Medicare in South Carolina covers Medicare Savings Programs.
When can I join or change a D-SNP?
If you have Medicaid or Extra Help, Medicare lets you make a change to your coverage once a calendar month, effective the first day of the next month. That lets you switch drug plans, return to Original Medicare with a stand-alone drug plan, or join an integrated D-SNP. You can also change plans during Open Enrollment, October 15 to December 7. If you're in a Healthy Connections Medicaid health plan when you first become eligible for Medicare, the state's contracts allow a plan's affiliated D-SNP to enroll you by default, with notice and the right to choose otherwise. Read any letter about default enrollment carefully.
What if I lose Medicaid while in a D-SNP?
SCDHHS describes a deeming period, a temporary time when someone is still considered eligible for a D-SNP after losing Medicaid. Its contracts allow a deeming period of at least 30 days and up to 6 months, set by the plan or the state. If your Medicaid isn't restored by then, the plan disenrolls you and you can choose other coverage. Respond quickly to any Healthy Connections Medicaid renewal notice to avoid a gap.
How do I choose between South Carolina D-SNPs?
- Decide whether you want one company managing both Medicare and Medicaid, or want to keep your current Medicaid plan.
- Check that your doctors and hospitals are in network. In York and Lancaster counties, many people use Charlotte-area hospitals, so confirm cross-state network access.
- Check every prescription on the plan's 2027 drug list.
- Compare extra benefits you would actually use.
- Confirm the plan enrolls your Medicaid category.
Our comparison of Original Medicare and Medicare Advantage with Extra Help helps if you're also weighing Original Medicare.
How The Jordan Insurance Agency can help
Since Prime ended, many South Carolina families have had to choose a new path for a parent with Medicare and Medicaid. We'll check which D-SNPs serve your address in Fort Mill, Rock Hill, Indian Land or elsewhere in the state, explain the difference between integrated and coordination-only plans, and compare them with Original Medicare. Schedule Your Consultation to review your options.
Reviewed by Billy Jordan Jr., licensed insurance agent · Licensing & Credentials · Last reviewed November 12, 2026 · Sources are linked in the answer above.
Licensing: Billy Jordan Jr. is licensed in 23 states, including North Carolina, South Carolina and Tennessee. See Licensing & Credentials.
Office: South Carolina clients are served by the Charlotte office, 3540 Toringdon Way, Suite 200, Charlotte, NC 28277, (704) 926-7565.
Medicare disclaimer: We do not offer every plan available in your area. Currently we represent 7 organizations which offer 70 products in your area (South Carolina). Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Read the full Medicare disclaimer.
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