The main setups
- Integrated D-SNP (FIDE or HIDE) + Florida Medicaid: a Medicare Advantage plan that also covers some or most of your Medicaid benefits under a contract with AHCA. A FIDE SNP covers Medicaid long-term care too, and its company also provides your Medicaid plan.
- Coordination-only D-SNP + Medicare Savings Program: for people with QMB, SLMB, QI or QDWI only. The plan covers Medicare and drugs and coordinates with Medicaid, which pays your Medicare premiums (and, with QMB, cost sharing).
- Original Medicare + Part D + Florida Medicaid: Medicare pays first, a standalone Part D plan covers drugs, and Medicaid pays after Medicare, through your SMMC plan if you have full Medicaid.
A regular Medicare Advantage plan with Medicaid alongside it is also possible. It isn't required to coordinate with Medicaid, so check that its providers also accept Florida Medicaid.
Side by side
| Question | Integrated D-SNP (FIDE or HIDE) | Coordination-only D-SNP | Original Medicare + Part D |
|---|---|---|---|
| Who can use it | Parts A and B, Medicaid in a group the plan accepts (full Medicaid for FIDE), living in its service area | Parts A and B, QMB, SLMB, QI or QDWI only (not full Medicaid), living in its service area | Anyone with Parts A and B |
| Plans in Florida, 2027 | 3 FIDE (42 counties), 60 HIDE (67 counties) | 64 (66 counties) | Original Medicare everywhere; 11 standalone Part D plans |
| Medicaid comes from | FIDE: the same company's Medicaid plan; HIDE: the plan covers some Medicaid benefits, the rest from Florida Medicaid | Florida Medicaid, which pays your Medicare premiums (and cost sharing with QMB) | Your SMMC Medicaid plan (full Medicaid) or the Medicare Savings Program |
| Doctors and hospitals | The plan's network | The plan's network | Any provider that accepts Medicare; for Medicaid services, providers in your Medicaid plan |
| Drug coverage | Included | Included | A separate Part D plan; Medicaid gives you Extra Help automatically |
| Long-term care | FIDE: included; HIDE: through the SMMC Long-Term Care program | Not covered; only full Medicaid can pay for long-term care | Through the SMMC Long-Term Care program if you qualify |
| Changing | Monthly switch to a standalone Part D plan; Open Enrollment | Monthly switch to a standalone Part D plan; Open Enrollment | Monthly Part D change; full duals can also join an integrated D-SNP monthly |
Source: CMS CY2027 Landscape file; AHCA D-SNP contract, Attachment I-B; 42 CFR 423.38.
Medicare Advantage plans may offer extra benefits such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.
Where PACE fits
PACE (Program of All-Inclusive Care for the Elderly) provides your Medicare and Medicaid care through one team. You must be 55 or older, live in a PACE service area, meet a nursing-home level of care and choose PACE as your only source of Medicare and Medicaid services (ESS 2040.0823). AHCA lists 12 PACE organizations, serving about two dozen Florida counties. You can leave PACE at any time (42 CFR 460.162). See Florida Medicaid long-term care.
Florida points to know
- Your Medicaid level decides your D-SNP choices. Florida's contract is unusual: coordination-only plans are for partial duals only, so full-Medicaid members choose among FIDE and HIDE plans.
- Full Medicaid means an SMMC plan. Florida law enrolls most Medicaid recipients, including people with Medicare, in Statewide Medicaid Managed Care (s. 409.965, s. 409.972). A FIDE SNP requires that your Medicaid plan come from the same company.
- Fewer D-SNPs for 2027. CMS counts 127 D-SNPs in Florida for 2027, down from 155 in 2026. If your plan is ending, see plans ending in 2027.
- MEDS-AD rarely applies. Most Floridians on Medicare get full Medicaid through SSI, Medically Needy or long-term-care Medicaid, not MEDS-AD. See What is MEDS-AD?
How to choose
- Confirm your Medicaid category. Full Medicaid, QMB, SLMB or QI? Your DCF notice says, or call DCF at (850) 300-4323.
- List your doctors, hospitals and drugs. Check each against the D-SNP's network and formulary, or the Part D plan's formulary, and confirm your providers also accept Florida Medicaid.
- Think about how much coordination you need. People with several conditions, frequent hospital stays or home care needs often value one plan working with Medicaid.
- Consider PACE if you're 55 or older and need nursing-home-level care. Ask AHCA whether a PACE organization serves your area.
- Make the change. For Medicare choices, call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048). For your SMMC Medicaid plan, call choice counseling at 1-877-711-3662. Changes generally start the first of the next month.
To talk through D-SNPs and other Medicare plans from the companies they work with, you can request a call from a licensed insurance agent. For details see D-SNPs in Florida, Florida Medicaid and Medicare and Medicare Savings Programs in Florida.
Sources
- AHCA — Medicare Advantage Dual Eligible Special Needs Plan contract, Attachment I-B
- CMS — Medicare Advantage and Part D Landscape files, contract years 2026 and 2027
- AHCA — Statewide Medicaid Managed Care
- Fla. Stat. 409.965, Mandatory enrollment
- Fla. Stat. 409.972, Mandatory and voluntary enrollment
- Florida DCF — ESS Policy Manual, Chapter 2000 (MEDS-AD, QMB, PACE)
- AHCA — September 2026 PACE Monthly Report
- Medicare.gov — Special Needs Plans (SNP)
- Medicare.gov — PACE
- eCFR — 42 CFR 422.2, definitions (FIDE SNP, HIDE SNP, aligned enrollment)
- eCFR — 42 CFR 423.38, enrollment periods
- eCFR — 42 CFR 460.162, voluntary disenrollment from PACE
Frequently asked questions
Is a D-SNP better than Original Medicare if I have Florida Medicaid?
It depends on your doctors, drugs and care needs. A D-SNP puts your Medicare care and drugs in one plan that must work with Florida Medicaid, but it uses a network. Original Medicare lets you see any provider that accepts Medicare, with a separate Part D plan. Check that your doctors and drugs are covered before you choose.
Can I join a coordination-only D-SNP with full Florida Medicaid?
No. AHCA's D-SNP contract says coordination-only D-SNPs may enroll only partial-benefit dual eligibles (QMB, SLMB, QI or QDWI). With full Medicaid, your D-SNP choices are FIDE and HIDE plans whose rules include you.
Can I leave a D-SNP if it doesn't work for me?
Yes. With Medicaid or Extra Help you can switch to a standalone Part D plan once per month, which returns you to Original Medicare. You can also change during Open Enrollment, October 15 to December 7.
Will my Medicaid plan change if I pick Original Medicare?
No. With full Medicaid you stay in your SMMC Medicaid plan, which pays after Medicare. Your Medicare choice and your Medicaid plan are separate unless you join a FIDE SNP, which requires that both come from the same company.
Medicare in your Florida county
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