Exclusively Aligned Enrollment

“Exclusively aligned enrollment” (EAE) occurs when a state limits D-SNP enrollment to full-benefit dually eligible individuals who receive their Medicaid benefits from the D-SNP or an affiliated Medicaid managed care plan offered by the same parent organization as the D-SNP. This requirement ensures that anyone who enrolls in the D-SNP is ultimately entitled to the same, unified package of benefits and facilitates several important benefits for plan enrollees, providers, and states. ICRC has compiled several resources for states to help states understand options for achieving EAE in a variety of state circumstances, relevant considerations and policy decisions, and key steps involved in implementing EAE.

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• Using Exclusively Aligned Enrollment to Integrate Medicare and Medicaid Benefits for Dually Eligible Individuals

  In this webinar, ICRC team members explain how exclusively aligned enrollment promotes integration of Medicare and Medicaid benefits for dually eligible individuals enrolled in Medicare Advantage Dual Eligible Special Needs Plans (D-SNPs), describe three models that states can use to achieve exclusively aligned enrollment in D-SNPs, and outline key considerations and steps for states in designing and implementing exclusively aligned enrollment. (ICRC, June 2023)

• Tools for States on Exclusively Aligned Enrollment in Dual Eligible Special Needs Plans: Introduction to Exclusively Aligned Enrollment

  This tip sheet provides a brief overview of exclusively aligned enrollment, as well as a summary of the benefits of EAE for dual eligible special needs plan (D-SNP) enrollees, providers, and states. (ICRC, June 2023)

• Tools for States on Exclusively Aligned Enrollment in Dual Eligible Special Needs Plans: Key Policy Decisions and Considerations for States Preparing for Exclusively Aligned Enrollment

  This tip sheet summarizes four key policy decisions for states preparing to implement EAE, as well as four factors that states may wish to consider when making those policy decisions. (ICRC, June 2023)

• D-SNP-Only Contracts: Benefits and Key Steps for States

  This webinar describes the opportunity for states to require Dual Eligible Special Needs Plans (D-SNPs) that operate with exclusively aligned enrollment to establish contracts with the Centers for Medicare & Medicaid Services (CMS) that only include one or more D-SNPs within a state and integrate certain materials for enrollees. (ICRC, March 2024)