Medicare Advantage Dual Eligible Special Needs Plan (D-SNP)

The Florida Master Agreement FP083 is an Indefinite Delivery Vehicle (IDV) for a Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) that provides comprehensive healthcare services for dual-eligible Medicare and Medicaid beneficiaries. The contract covers a wide range of medical services, including behavioral health, dental, durable medical equipment, and nursing facility services, targeting specific eligibility categories such as Qualified Medicare Beneficiaries (QMB), QMB Plus, Specified Low-Income Medicare Beneficiaries (SLMB), Qualifying Individuals (QI), Qualified Disabled and Working Individuals (QDWI), and Full Benefit Dual Eligible (FBDE) populations across multiple Florida counties.

The master agreement is awarded to CareNeeds Health Plans Inc. (now part of Humana, Inc.) by the Florida Agency for Health Care Administration, with a contract period from January 1, 2021, to December 31, 2025. The contract covers service areas in numerous Florida counties, including Broward, Miami-Dade, Palm Beach, Hillsborough, Brevard, Duval, and others. As a Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP), the contract includes two specific plan offerings: CareNeeds Platinum (HMO D-SNP) and CareNeeds Plus (HMO D-SNP), with capitation rates varying by region and eligibility category, ranging from approximately $8 to $111 per member per month.