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Informational Resources
Elevance SNP 2025 Enrollment At-A-Glance
HIDE/FIDE D-SNP Opportunities- 2025
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 state of 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
List of Humana Plans Click Here! *(On the Last Page)*
Aetna has 2025 D-SNP Hot Sheets by State
State Hot Sheets HERE