There is no plan officially called a “Medicaid Advantage plan.” What most people mean by this term is a Dual Eligible Special Needs Plan, or D-SNP, which is a type of Medicare Advantage plan designed specifically for people who qualify for both Medicare and Medicaid. These plans bundle your Medicare and Medicaid benefits into one package, with a single card, a single network, and a care team that coordinates everything. Over 8 million people were enrolled in special needs plans as of early 2026, and that number has tripled since 2018.
Why the Name Causes Confusion
Medicare Advantage is the private-plan alternative to Original Medicare. Medicaid is the separate, state-run program for people with low incomes. They sound similar but cover different populations with different rules. When someone qualifies for both programs at the same time (called “dual eligible”), navigating two separate systems with two sets of rules, two provider networks, and two sets of paperwork can be overwhelming. D-SNPs exist to solve that problem by pulling both programs together under one plan.
You may also hear the terms FIDE SNP (Fully Integrated) and HIDE SNP (Highly Integrated). These are variations of the same concept with different levels of integration. A FIDE SNP covers the widest range of services under one roof, including long-term care, behavioral health, home health, and medical equipment. A HIDE SNP covers a narrower set of Medicaid benefits, typically either long-term care or behavioral health, but not necessarily both. In either case, the goal is the same: fewer gaps between your Medicare and Medicaid coverage.
Who Qualifies
To enroll in a D-SNP, you need to be eligible for both Medicare and some form of Medicaid. Medicare eligibility typically comes from being 65 or older, or from having a qualifying disability. Medicaid eligibility depends on your income, your assets, and your state’s specific rules.
The federal government sets baseline income thresholds tied to the federal poverty level. For 2026, the broadest category (Qualified Medicare Beneficiary, or QMB) allows individual monthly income up to $1,350 in most states, with an asset limit of $9,950. Couples can earn up to $1,824 per month with $14,910 in assets. Higher income tiers exist for partial Medicaid benefits: the Specified Low-Income Medicare Beneficiary category covers individuals earning up to $1,616 per month, and the Qualifying Individual category covers up to $1,816 per month. Alaska and Hawaii have higher limits. Your state Medicaid office can tell you exactly which category you fall into, since some states set their own thresholds above the federal floor.
What These Plans Cover
D-SNPs cover everything a standard Medicare Advantage plan covers: hospital stays, doctor visits, preventive care, and prescription drugs. On top of that, they layer in Medicaid-covered services that standard Medicare Advantage plans don’t touch. Depending on the plan type and your state, this can include long-term nursing facility care, home and community-based services, personal care aides, behavioral health treatment, and medical equipment.
Many D-SNPs also offer supplemental benefits tailored to the populations they serve. These might include extra days of hospital coverage for people with serious chronic conditions, transportation to medical appointments, or expanded coverage for dental and vision care. The exact extras vary by plan and by region, so two D-SNPs in the same city can look quite different.
How Care Coordination Works
The biggest practical difference between a D-SNP and having separate Medicare and Medicaid coverage is coordination. When you enroll, your plan is required to conduct a health risk assessment that looks at your medical needs, your daily functioning, and your social circumstances (things like housing stability and access to food). Based on that assessment, the plan builds an individualized care plan.
An interdisciplinary care team manages that plan. This team typically includes your primary care doctor, relevant specialists, and social service providers. You’re part of the team too. The idea is that everyone involved in your care can see the full picture rather than working in silos. If you’re admitted to a hospital, for example, the plan is required to coordinate your discharge so that follow-up services like home health visits or medication changes are already arranged before you leave. Plans must maintain technology systems that allow real-time data sharing and notifications across providers, which reduces the chance of falling through the cracks between your Medicare and Medicaid benefits.
What You’ll Pay
Most D-SNPs are designed to cost members little or nothing out of pocket. Many plans offer zero-dollar monthly premiums and zero-dollar cost sharing for Medicare-covered services. At the time a plan is created, it must declare whether it’s a “zero-dollar cost sharing” plan or not. For people with full Medicaid benefits, the integrated plans that CMS evaluates for passive enrollment are held to a standard of no premium and no cost sharing.
Your Medicaid coverage also helps pay costs that would otherwise come out of your pocket, like Medicare Part B premiums, deductibles, and copays. The exact amount of financial protection depends on which Medicaid eligibility category you fall into. Someone with full Medicaid gets the most comprehensive cost-sharing relief, while someone in a partial category like QMB-only still gets help with Medicare premiums and cost sharing but may not receive the full range of Medicaid-covered services.
How to Enroll or Switch Plans
If you’re dual eligible, you have more flexibility to enroll or change plans than most Medicare beneficiaries. A special enrollment period allows full-benefit dual eligible individuals to make one plan change per month, rather than waiting for the annual open enrollment window that applies to everyone else. You can use this monthly option to enroll in a FIDE SNP, HIDE SNP, or other applicable integrated plan, as long as your Medicaid managed care enrollment aligns with the D-SNP you’re choosing.
There’s one important catch: you can only use this integrated care special enrollment period if your Medicaid coverage will actually be aligned with the D-SNP. If you’re staying in Medicaid fee-for-service or an unrelated Medicaid managed care organization, the monthly switch option doesn’t apply. You’d still have a separate enrollment period that lets you move between standalone prescription drug plans or switch to Original Medicare on a monthly basis.
Rapid Growth in These Plans
Enrollment in special needs plans has grown dramatically. In 2018, about 2.6 million people were enrolled. By 2024, that number reached 6.6 million. In February 2026, it hit 8.1 million. That growth accounted for 83% of all Medicare Advantage enrollment increases over the past year. Special needs plans now make up 23% of total Medicare Advantage enrollment, up from 13% in 2018. Congress made these plans a permanent part of Medicare in 2018, which gave insurers the certainty to invest in building them out across more states and counties.
This growth reflects both increased awareness and expanded availability. More insurers are offering D-SNPs in more regions, and states have been signing new contracts that allow deeper integration between their Medicaid programs and these Medicare Advantage plans. For people who qualify, the practical result is more choices and, in many areas, better-coordinated care than managing two separate programs on your own.