Feb 1, 2024

D-SNP coinsurance reminder

Effective January 1, 2024, all existing and new Blue RI for Duals (D-SNP) members received new ID cards and Flexible Spending Cards. The new ID cards no longer display the copays or coinsurance. Consistent with 2023, D-SNP members have a 20% coinsurance on some services such as PCP visits (excluding annual physical), medical services related to X-rays, specialist visits, and Part B DME supplies. Any D-SNP copay or coinsurance should be billed to Medicaid. If you are not an approved Medicaid provider and are unable to submit your claim to Medicaid, you are not allowed to bill the member for the copay/coinsurance.

Denial reason code according to your provider remittance advice: 

MA1This is a Dual-Eligible Beneficiary. Member may not be responsible for any cost share.