What Does "Dual Eligible" Mean?
You are considered "dual eligible" if you qualify for both Medicare (federal health insurance for people 65+ or with certain disabilities) and Medicaid (state-federal health insurance for people with limited income and resources). In Florida, approximately 800,000 people are dual eligible.
Being dual eligible opens the door to a special category of Medicare Advantage plan called a Dual Eligible Special Needs Plan (D-SNP) — and for most people who qualify, it's the best coverage option available.
What Is a D-SNP?
A Dual Eligible Special Needs Plan is a type of Medicare Advantage plan specifically designed for people who have both Medicare and Medicaid. D-SNPs are required to coordinate benefits between Medicare and Medicaid, which means:
- Reduced or eliminated cost-sharing (copays, deductibles, coinsurance)
- Coordinated care management between your Medicare and Medicaid benefits
- Extra benefits beyond standard Medicare Advantage, often including transportation, meals, personal care, and more
- $0 or very low monthly premiums in most cases
Types of Dual Eligible Status
Not all dual eligibles have the same level of Medicaid benefits. Your specific dual eligible category affects what D-SNP benefits you can access:
| Category | Description | Cost-Sharing Help |
|---|---|---|
| Full Dual (FBDE) | Full Medicaid benefits | Medicare premiums, deductibles, and copays covered by Medicaid |
| QMB Only | Qualified Medicare Beneficiary | Part A/B premiums and cost-sharing covered |
| SLMB Only | Specified Low-Income Medicare Beneficiary | Part B premium covered |
| QI | Qualifying Individual | Part B premium covered (limited slots) |
| QDWI | Qualified Disabled Working Individual | Part A premium covered |
D-SNP Benefits in Florida for 2026
Florida D-SNP plans in 2026 typically include benefits that go well beyond standard Medicare Advantage:
- $0 monthly premium (most plans)
- $0 copays for most services (for full duals)
- Dental coverage — cleanings, X-rays, extractions, sometimes dentures
- Vision coverage — exams, frames, lenses
- Hearing coverage — exams and hearing aids
- Transportation — non-emergency medical transportation
- OTC allowance — monthly credit for over-the-counter health products
- Meals — post-hospitalization meal delivery (some plans)
- Personal emergency response systems
- Care coordination — dedicated care manager for complex needs
How to Enroll in a D-SNP in Florida
Unlike standard Medicare Advantage plans that can only be changed during AEP (Oct 15–Dec 7), dual eligible individuals have a monthly Special Enrollment Period. This means you can enroll in, switch, or disenroll from a D-SNP any month of the year.
To enroll, you must:
- Be enrolled in Medicare Parts A and B
- Have current Medicaid eligibility in Florida
- Live in the plan's service area
- Select a D-SNP plan available in your county
Is a D-SNP Right for You?
If you qualify for both Medicare and Medicaid, a D-SNP is almost always worth exploring. The combination of $0 premiums, reduced cost-sharing, and extra benefits makes D-SNPs one of the most comprehensive coverage options available to any Medicare beneficiary.
The key is finding the right D-SNP in your county — plan benefits, networks, and drug formularies vary significantly between carriers.
At Integrity Health Solutions, we specialize in helping dual eligible Floridians navigate D-SNP options. Check your D-SNP eligibility or book a free consultation to compare plans in your area.
Have questions about your coverage?
Our team offers free, no-pressure consultations for Florida residents. We compare every option available in your county.