What "fully integrated" means
Most people with both Medicare and Medicaid get them from two places: Medicare (or a Medicare plan) pays first, and a separate Medicaid plan picks up Medicaid services. A FIDE SNP puts both under one company. Under the federal definition in 42 CFR 422.2, the company must hold both a Medicare Advantage contract with CMS and a Medicaid managed care contract with the state, and its Medicaid contract must cover:
- primary and acute care, including Medicare cost sharing;
- long-term services and supports, including at least 180 days of nursing facility care in a plan year;
- behavioral health, home health, and medical supplies and equipment.
AHCA's D-SNP contract repeats these requirements and adds a Florida detail: a FIDE SNP must also follow the company's SMMC Long-Term Care program contract. That's what sets it apart from other Florida D-SNPs.
Florida's three kinds of D-SNP
| Type (AHCA) | What the Medicaid side covers | 2027 plans (CMS) |
|---|---|---|
| FIDE SNP | Medicare plus Medicaid, including long-term care, from one company | 3 plans, 42 counties |
| HIDE SNP | Medicare plus some Medicaid benefits, including behavioral health, under a capitated contract with AHCA | 60 plans, all 67 counties |
| Coordination-only D-SNP | Coordinates with Medicaid; may enroll only people with QMB, SLMB, QI or QDWI | 64 plans, 66 counties |
For 2026 Florida had 2 FIDE SNPs; for 2027 it has 3, out of 127 D-SNPs in all.
Where FIDE SNPs are offered in 2027
CMS's CY2027 Landscape file lists FIDE SNPs in Alachua, Baker, Bradford, Brevard, Broward, Citrus, Clay, Columbia, Dixie, Duval, Flagler, Gilchrist, Hamilton, Hardee, Hernando, Highlands, Hillsborough, Indian River, Lafayette, Lake, Levy, Manatee, Marion, Martin, Miami-Dade, Nassau, Okeechobee, Orange, Osceola, Palm Beach, Pasco, Pinellas, Polk, Putnam, Sarasota, Seminole, St. Johns, St. Lucie, Sumter, Suwannee, Union and Volusia counties. Not every FIDE SNP serves every one of these counties.
How to check and join
- Confirm your Medicaid. A FIDE SNP needs full Medicaid. Your DCF notice or MyACCESS account shows your coverage group.
- Know the timing. Besides Open Enrollment (October 15 to December 7), people with full Medicaid can join an integrated D-SNP once a month under 42 CFR 423.38(c)(35).
- Line up the Medicaid side. Medicaid plan choices go through Florida's SMMC Choice Counseling line, 1-877-711-3662.
- Compare. You can request a call from a licensed insurance agent to review D-SNPs from the companies they work with, or call 1-800-MEDICARE.
More in D-SNPs in Florida and D-SNP vs. Original Medicare with Florida Medicaid.
Related questions
What is a D-SNP in Florida?
Medicare Advantage plans for people with both.
Do I have to join a Medicaid managed care plan if I have Medicare?
How SMMC works with Medicare.
What is the SMMC Long-Term Care program?
Nursing home and in-home care through Medicaid.
Sources
- eCFR — 42 CFR 422.2, definitions (fully integrated D-SNP, aligned enrollment)
- AHCA — Attachment I-B, Medicare Advantage Dual Eligible Special Needs Plan (DSNP) Program
- eCFR — 42 CFR 423.38, enrollment periods (integrated D-SNP special enrollment period)
- CMS — CY2026 and CY2027 Landscape files
- AHCA — Pick a Long-Term Care Plan (Choice Counseling)
More questions in this guide
- Do I have to join a Medicaid managed care plan if I have Medicare in Florida?
- Can I have Medicare and Medicaid at the same time in Florida?
- Can permanent residents get Florida Medicaid?
- How do I renew my Florida Medicaid on ACCESS Florida?
- What is a dual eligible special needs plan (D-SNP) in Florida?
- What is MEDS-AD Medicaid in Florida?
- What is the Florida Medicaid Long-Term Care program (SMMC LTC)?
Part of the guide: Florida Medicaid and Medicare together · All questions
Frequently asked questions
Who can join a FIDE SNP in Florida?
People with Medicare Parts A and B and full Florida Medicaid who live in the plan's service area. Federal rules require a FIDE SNP to have exclusively aligned enrollment, so your Medicaid must also be with the same company.
Can I join a FIDE SNP if I only have QMB or SLMB?
No. A FIDE SNP is for people with full Medicaid. In Florida, people who get only a Medicare Savings Program (QMB, SLMB or QI) can look at coordination-only D-SNPs, which AHCA's contract limits to partial-benefit dual eligibles.
When can I switch into a FIDE SNP?
Since 2025, people with full Medicaid have a special enrollment period once a month to join an integrated D-SNP such as a FIDE SNP, as long as it aligns their Medicare and Medicaid with the same company.
Is a FIDE SNP available in my county?
For 2027, CMS lists FIDE SNPs in 42 of Florida's 67 counties, including Miami-Dade, Broward, Palm Beach, Hillsborough, Orange and Duval. None is offered in the 25 other counties, which include the Panhandle from Escambia to Leon and Taylor, and Lee, Collier, Charlotte, DeSoto, Glades, Hendry and Monroe.
Medicare in your Florida county
Plans, local agents and help, county by county: Miami-Dade · Broward · Palm Beach · Hillsborough · Orange · Duval · Pinellas · Lee · Polk · Pasco · Brevard · Volusia · Seminole · Sarasota · Osceola · Manatee · Lake · Marion · Collier · St. Lucie · All 67 counties →
