What is a D-SNP?
A dual eligible special needs plan (D-SNP) is a type of Medicare Advantage plan limited to people who have Medicare and Medicaid. It covers Part A, Part B and Part D services and must coordinate with your state Medicaid benefits. Federal rules (42 CFR 422.2) set three levels of integration:
- Fully integrated (FIDE SNP): one organization covers Medicare and Medicaid, including long-term services and supports.
- Highly integrated (HIDE SNP): covers Medicare plus some Medicaid benefits. Ohio has none.
- Coordination-only: covers Medicare and coordinates with Medicaid, which still pays its share separately.
How D-SNPs work in Ohio
Ohio built its D-SNP policy around Next Generation MyCare Ohio, statewide since August 1, 2026. Under the Ohio Department of Medicaid's contract with the MyCare plans:
- Each MyCare plan must offer a FIDE SNP for its members' Medicare benefits, with exclusively aligned enrollment, so you get Medicare and Medicaid from the same plan.
- MyCare organizations may offer a separate coordination-only D-SNP only to partial-benefit dual eligibles, meaning people with QMB, SLMB, QI or QDWI and not full Medicaid. They may not offer a coordination-only D-SNP to people with full Medicaid.
CMS's 2027 plan data reflects this. Every D-SNP in Ohio for 2027 belongs to one of the four MyCare organizations: 6 FIDE SNP plans and 4 coordination-only D-SNP plans, all offered in all 88 counties. CMS's 2027 data lists 46 special needs plans of all types in Ohio, including plans for chronic conditions and for people in institutions. This site doesn't name plans; the Ohio Medicaid Consumer Hotline (1-800-324-8680, ohiomh.com) lists the MyCare plans.
In 2026, many other companies offered coordination-only D-SNPs in Ohio. None of them continue for 2027. If you had one, you should have received a non-renewal notice. See Ohio plans ending in 2027 for your special enrollment period and Medigap rights.
Which option fits your Medicaid
| Your Medicaid | D-SNP you can join | Other Medicare choices |
|---|---|---|
| Full Medicaid, age 21+, with Parts A, B and D | The FIDE SNP of your MyCare plan (one plan for both) | Original Medicare with a Part D plan, or a regular Medicare Advantage plan, while MyCare covers Medicaid only |
| QMB, SLMB, QI or QDWI only | A coordination-only D-SNP | Original Medicare with a Part D plan (and Medigap if you want it), or a regular Medicare Advantage plan |
| Full Medicaid and in PACE | None: PACE covers Medicare and Medicaid | You would leave PACE to choose another option |
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.
When you can join or switch
- Open Enrollment, October 15 to December 7. Anyone with Medicare can change plans for January 1. Open Enrollment for 2027 is under way now.
- Monthly integrated-care period. People with full Medicaid can join the FIDE SNP that matches their MyCare plan in any month (42 CFR 423.38(c)(35)). The Ohio Department of Medicaid says MyCare members can align Medicare at any time through Medicare.
- Monthly Part D period. People with Medicaid or Extra Help can switch to a standalone Part D plan once per month, which also returns them to Original Medicare if they were in a Medicare Advantage plan (42 CFR 423.38(c)(4)).
- When your Medicaid changes. If you gain, lose or change Medicaid or Extra Help, you get a special enrollment period. If you lose Medicaid, your D-SNP must give you a period of deemed continued eligibility, as its notice explains, before it ends your coverage.
Changes generally start the first day of the next month. Call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048) or the Ohio Medicaid Consumer Hotline (1-800-324-8680). To review plans from the companies they work with, you can request a call from a licensed insurance agent.
Before you join a D-SNP
- Check that your doctors, hospitals and pharmacies are in the plan's network.
- Check your drugs on the plan's formulary.
- Keep your Medicaid renewal up to date: losing Medicaid can end your D-SNP eligibility.
- If you have QMB, providers may not bill you for Medicare cost sharing, whichever Medicare option you pick. See Can a doctor bill me if I have QMB?
See also MyCare vs. Original Medicare and Medicaid and Ohio Medicaid and Medicare.
Sources
- Medicare.gov — Special Needs Plans (SNP)
- Ohio Department of Medicaid — Next Generation MyCare Provider Agreement (2027), Attachment 1
- Ohio Administrative Code — Rule 5160-58-02, MyCare Ohio eligibility and enrollment
- CMS — Medicare Advantage/Part D contract and enrollment data (CY2026 and CY2027 Landscape files)
- eCFR — 42 CFR 423.38, enrollment periods
- eCFR — 42 CFR 422.2, definitions (FIDE SNP, HIDE SNP)
- CMS — Qualified Medicare Beneficiary program
Frequently asked questions
What is the dual special enrollment period?
Federal rules give people with Medicaid or Extra Help two monthly options. Once per month you can switch to a standalone Part D plan (which can take you from Medicare Advantage back to Original Medicare), under 42 CFR 423.38(c)(4). And people with full Medicaid can join a fully integrated D-SNP that matches their Medicaid plan once per month, under 423.38(c)(35). Changes start the first of the next month.
Can I join a D-SNP in Ohio if I have only QMB or SLMB?
Yes, if you have Medicare Part A and Part B and live in the plan's service area. In Ohio, people who get only a Medicare Savings Program (QMB, SLMB, QI or QDWI) and not full Medicaid can join a coordination-only D-SNP. They aren't eligible for MyCare Ohio, which requires full Medicaid.
Can I join a D-SNP from a different company than my MyCare plan?
Not if you have full Medicaid. Ohio's MyCare contract uses exclusively aligned enrollment: the D-SNP you can join is the one run by the same organization as your MyCare plan, so one plan covers both Medicare and Medicaid. To use another company's Medicare plan, you would keep MyCare for Medicaid only.
Why did my D-SNP end for 2027?
For 2027, the only D-SNPs in Ohio are those offered by the four MyCare organizations, so other companies' 2026 D-SNPs did not continue. If your plan is ending, you get a non-renewal notice and a special enrollment period. See the 2027 plan endings page.
Medicare in your Ohio county
Plans, local agents and help, county by county: Franklin · Cuyahoga · Hamilton · Summit · Montgomery · Lucas · Butler · Stark · Lorain · Warren · Delaware · Lake · Mahoning · Clermont · Trumbull · Licking · Medina · Greene · Fairfield · Portage · All 88 counties →
