This page is designed to help you understand the most recent eligibility and enrollment criteria for selling D-SNPs. Once you’ve verified your client’s D-SNP eligibility (See the Dual Special Needs Plans page) you are then able to enroll the client into a UnitedHealthcare D-SNP following the appropriate enrollment period. The table below outlines the times when you can enroll eligible clients into a D-SNP.

Beginning in 2027, new CMS enrollment requirements apply to Full Dual eligible individuals (FBDE, QMB+, SLMB+) enrolling in certain UHC D-SNPs. View the Medicaid Categories of Eligibility (COE) Guide to learn more about Full, QMB and Partial categories and how they are classified.

To enroll in a UHC Fully Integrated Dual Eligible (FIDE) or Highly Integrated Dual Eligible (HIDE) plan, eligible consumers must either: 

• Already be enrolled in UnitedHealthcare Medicaid, or
• Be enrolling in a plan that allows Medicaid alignment through the enrollment process

Requirements vary by state and plan. See the applicable state At-a-Glance documents for details.

Two Enrollment Pathways

Additionally, each state / plan has a specified enrollment pathway designating the alignment process for integrated plans (FIDEs, HIDEs):

• Medicare-First Enrollment: Consumers can enroll in UHC’s D-SNP first. After enrollment, their Medicaid coverage will automatically transition to UHC, if required by the state.
  • States / Plans: AZ, CO, DC, FL (HIDE), ID, IN, MA, MI, NJ, TX (FIDE), VA
• Medicaid-First Enrollment: Consumers must first enroll in a UHC Medicaid plan before they can enroll in the UHC D-SNP. Because agents generally cannot assist with Medicaid enrollment, consumers should be directed to their state Medicaid agency for enrollment assistance.
  • States / Plans: FL (FIDE), HI, KS, KY, NE, NM, NY^*, TN, TX (HIDE), WA, WI^**

_{^*During AEP, consumers enrolling in a non-MAP UHC Full Dual plan in New York must either be in UHC’s Medicaid or in the state’s Fee-For-Service Medicaid program.}

_{^**During AEP, consumers enrolling in a UHC Full-Dual plan in Wisconsin must either be in UHC’s Medicaid or the state’s Fee-For-Service Medicaid program.}

The Integrated Care SEP allows a once-per-month election for Full Dual eligibles (QMB+, SLMB+, FBDE) to enroll into a Fully Integrated Dual Eligible (FIDE), Highly Integrated Dual Eligible (HIDE) or an Aligned Integrated Plan (AIP) Special Needs Plan (SNP).