Definitions of Different Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) Types in 2023 and 2025
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Supporting States in Improving Care for Dually Eligible Individuals through the Integrated Care Resource Center
Prepared for:
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Medicare - Medicaid Coordination Office
Dual Eligible Special Needs Plans (D-SNPs) must hold contracts with state Medicaid agencies, and states can use contractual requirements to better integrate and coordinate care for individuals who are dually eligible for Medicare and Medicaid. Federal rules issued in 2019 defined three different types of D-SNPs: “fully” integrated D-SNPs (FIDE SNPs); “highly” integrated D-SNPs (HIDE SNPs); and Coordination-only (CO) D-SNPs, and also defined “applicable integrated plans” (AIPs). New rules issued in May 2022 updated those definitions.
This tip sheet summarizes the updated definitions of FIDE SNPs, HIDE SNPs, CO D-SNPs, and AIPs for 2023 and compares the requirements for each D-SNP type. This information can be helpful to states as they develop and implement programs that advance Medicare-Medicaid integration for their dually eligible populations.
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