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

This Master Agreement establishes a comprehensive Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) vehicle designed to serve dual-eligible beneficiaries throughout Florida. The contract authorizes the operation of multiple Plan Benefit Packages (PBPs) classified as either Highly Integrated Dual Eligible (HIDE) SNPs or Fully Integrated Dual Eligible (FIDE) SNPs across nine service regions spanning all Florida counties. Services available under this IDV include coordinated Medicare Part C and D benefits with Medicaid services, comprehensive behavioral health services, long-term care and supports, home health services, medical supplies and equipment, prescription drug coverage, emergency and hospital services, nursing facility care, and specialty services in accordance with Florida Medicaid Coverage Policies. The contract requires integrated care management and case coordination for high-risk beneficiaries, with the FIDE SNP component specifically providing up to 365 days of all-inclusive nursing facility services annually through capitated Medicaid payments.

Humana Medical Plan, Inc. serves as the prime contractor for this Master Agreement, with the Agency for Health Care Administration (AHCA) as the contracting organization. The contract period extends from January 1, 2026, through December 31, 2028, with options for renewal for up to three additional years contingent upon satisfactory performance and fund availability. The contract is geographically limited to Florida and is classified as a Master Agreement with a total contract value not to exceed $143,200,113.94, subject to annual legislative appropriation. Humana is required to maintain a performance bond of $14,320,011.39 and comply with all applicable federal Medicare Advantage regulations and state Medicaid requirements.