If you have both Medicare and Medicaid, a letter may arrive this fall saying your plan will not continue next year. That letter is worth reading closely, but it is not a reason to panic. You have time, you have choices, and you will not be left without coverage.
A lot of people with both Medicare and Medicaid are in a Dual Eligible Special Needs Plan, often shortened to D-SNP. It is a type of Medicare Advantage plan built for people who qualify for both programs. Each year, some insurance companies decide not to offer certain plans again the next year. For 2027, there is an extra reason some D-SNPs may change or go away, and I want to walk through what that means for you.
Why some D-SNPs are changing for 2027
In 2024, the Centers for Medicare & Medicaid Services (CMS) finalized new rules for D-SNPs that begin in 2027. The goal is to line up a person’s Medicare plan and Medicaid plan so both are run by the same company and work together.
Here is the short version. Starting in 2027, if an insurance company runs a D-SNP and also runs a Medicaid managed care plan in the same area, that company can generally offer only one D-SNP there for people with full Medicaid benefits. That D-SNP can also only take new members who are enrolled in, or in the process of enrolling in, that same company’s Medicaid plan. CMS allows a few limited exceptions.
People who are already in one of these plans and whose Medicaid plan is with a different company can generally stay until 2030. By 2030, these plans must only serve members whose Medicare and Medicaid plans match.
Because of this, some companies that offered several D-SNPs in the same area are combining them into one for 2027. Others may decide to end a D-SNP in some places. If you are affected, your plan will tell you.
The letters to watch for
If your plan is leaving Medicare or not renewing, Medicare.gov says your plan sends a Plan Non-Renewal Notice in October. The notice tells you that you need to look for a new plan for next year.
If you get Extra Help paying for drugs, Medicare also sends its own reminder in November. It is called the CMS Non-Renewal Reminder Notice, and it repeats that you need to choose a new plan for the coming year.
It helps to know that not every change means your plan is ending. When a company combines plans, it may move you into its remaining plan instead. In that case, your plan would send you a letter explaining what your coverage looks like next year. Read whatever arrives carefully so you know which situation you are in.
Your windows to make a change
You have more than one chance to pick a new plan.
Open Enrollment, October 15 to December 7. This is the regular window everyone with Medicare has each fall. Changes you make during this time take effect on January 1.
A special window when your plan is not renewing. If your plan has told you it is not renewing, Medicare.gov says you can switch to another plan between December 8 and the last day of February of the following year. This gives you extra time if you miss Open Enrollment.
A monthly option for people with Medicaid or Extra Help. If you have Medicaid or get Extra Help, you can make certain changes once a calendar month, with the change taking effect on the first day of the next month. For example, you can switch Medicare drug plans. If you have full Medicaid benefits, you can also join or switch to an integrated D-SNP, which is a plan that combines your Medicare and Medicaid benefits and helps coordinate your care, once a month if one is available where you live.
The monthly option is helpful, but I would not count on it as your only plan. Choosing during the fall gives you the most time to compare and ask questions before January.
A plan ending is not the same as losing Medicare. Your Medicare and your Medicaid stay in place. Only the plan that delivers them changes.
What happens if you do nothing
If your Medicare Advantage plan is not renewing and you do not join another Medicare Advantage plan before it ends, Medicare.gov says you will be enrolled in Original Medicare. You do not lose your Medicare.
For drug coverage, people with full Medicaid benefits get Extra Help automatically. Medicare.gov says that if you have Extra Help and do not already have a Medicare drug plan, Medicare will automatically enroll you in one. You will get a letter telling you which plan that is.
So you will not be left with nothing. But doing nothing means someone else picks your drug plan, and it may not include the pharmacy you use or cover your medicines in the way you are used to. You also lose the care coordination and extra support many D-SNP members rely on. Making your own choice is almost always worth the effort.
What you can look at instead
Your options depend on your Medicaid coverage and on what is available where you live. Some choices people in this situation often look at include:
- Another D-SNP. This could be the D-SNP run by the same company as your Medicaid plan, or another D-SNP you qualify for. Starting in 2027, some D-SNPs can only accept you if your Medicaid plan is with the same company, so your Medicaid plan matters here. You can read more about how these plans work on my dual eligible special needs plan page.
- Next Generation MyCare Ohio. For people with full Medicaid benefits who qualify, this is another option worth asking about.
- Original Medicare with a separate drug plan. My Medicare Part D page explains how stand alone drug plans work.
I am not going to tell you which plan to pick in this post. The right fit depends on your doctors, your medicines, your pharmacy, and how your Medicaid is set up. Plan details for 2027 are also not available to share yet.
A simple checklist for this fall
- Open every letter from your plan and from Medicare. Set aside anything that mentions 2027, non-renewal, or changes.
- Write down your doctors and your pharmacy. You will want to confirm they work with any new plan.
- Make a list of every medicine you take, including the dose.
- Find your Medicaid card and your Medicaid plan name. For 2027, your Medicaid plan can affect which D-SNPs you are able to join.
- Mark October 15 and December 7 on your calendar. Plan to make your choice inside that window if you can.
- Ask for help if you need it. You can also call 1-800-MEDICARE with questions, or contact your local State Health Insurance Assistance Program for free help.
If you want to go through everything at once, my annual plan review is built for exactly this kind of change.
Let me help you sort it out
If you get a letter saying your D-SNP is ending, or you are just not sure whether your plan is affected, I am glad to look at it with you. I work with people across the Mahoning Valley and Western Pennsylvania, and there is no cost for my help.
During Open Enrollment I can sit down with your letters, your medicine list, and your Medicaid information and walk through the options that fit your situation. You can call me at 330-227-4402 or book a time through my contact page.
Reviewed by a licensed agent on September 28, 2026.