Informational Resources
Understanding LIS
Understanding Dual Eligible Plans
HIDE- SNP
“Highly Integrated Dual Special Needs Plan”
Less integrated than FIDE-SNPs
Must cover either behavioral health or long-term services and supports (LTSS)
May exclude some other Medicaid services
Created to implement new requirements for D-SNPs in the Bipartisan Budget Act of 2018
FIDE-SNP
“Fully Integrated Dual Special Needs Plan”
Provide nearly all Medicaid services, including LTSS, behavioral health, home health, and durable medical equipment (DME)
Require Exclusively Aligned Enrollment (EAE)
May be eligible for payment adjustments to account for the cost of serving a high concentration of frail individuals
All D-SNPs MUST Meet Certain Requirements
Coordinating Medicaid benefits for their members
Having a State Medicaid Agency Contract (SMAC) with each state they operate in
Satisfying the criteria for integrating Medicare and Medicaid benefits
Dual/LIS Special Election Period Change
Starting in 2025, full dual-eligible beneficiaries will have access to a new monthly SEP, which allows enrollment in highly or fully integrated Dual Special Needs Plans (HIDE/FIDE SNPs). In addition, any beneficiary qualified for LIS or Medicaid will be eligible for a monthly SEP to disenroll from their Medicare Advantage plan, return to Original Medicare, and enroll in a Prescription Drug Plan (PDP).
The quarterly SEP that many have used in the past for dual-eligible individuals and those receiving Part D low-income subsidies (LIS) is no longer available. The SEP available for the first 3 quarters of the year ended on September 30, 2024.
UHC has Individual State Guides
State Guides HERE or on Jarvis.
Here are instructions to get there: Jarvis>Knowledge Center>Medicare Product Resources>Dual Eligible Special Needs Plans>State-Level D-SNP Enrollment at a Glance Guides>State (click on the state of the client’s residence)
Devoted 2025 SNP FAQ
Starting in 2025, full dual-eligible beneficiaries will have access to a new monthly SEP, which allows enrollment in highly or fully integrated Dual Special Needs Plans (HIDE/FIDE SNPs). In addition, any beneficiary qualified for LIS or Medicaid will be eligible for a monthly SEP to disenroll from their Medicare Advantage plan, return to Original Medicare, and enroll in a Prescription Drug Plan (PDP).
The quarterly SEP that many have used in the past for dual-eligible individuals and those receiving Part D low-income subsidies (LIS) is no longer available. The SEP available for the first 3 quarters of the year ended on September 30, 2024.
Wellcare 2025 Dual Eligible Plan Enrollment Guide
Humana HIDE/FIDE D-SNP Guide
Aetna has 2025 D-SNP Hot Sheets by State
Molina has a 2025 Plan guide which shows HIDE/FIDE/AIP
Elevance SNP 2025 Enrollment Guide