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

Florida Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) Master Agreement Summary

This Master Agreement establishes a comprehensive Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) designed to deliver integrated healthcare services to beneficiaries who qualify for both Medicare and Medicaid. The contract authorizes the provision of a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP) that consolidates Medicare Part A, Part B, and Part D benefits with extensive Medicaid-covered services under a single coordinated entity. Covered services include primary and acute care, behavioral health, long-term care services and supports, home health services, nursing facility care (up to 365 days annually for eligible FIDE SNP enrollees), durable medical equipment, prescription drugs, emergency services, and specialized therapeutic services. The plan serves dual-eligible beneficiaries across eight designated service regions (Regions A through G, and Region I) and encompasses multiple Medicaid eligibility categories including Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Full Benefit Dual Eligible (FBDE) populations.

UnitedHealthcare of Florida, Inc., headquartered in Maitland, Florida, serves as the prime contractor under this Master Agreement administered by the State of Florida's Agency for Health Care Administration (AHCA). The contract period extends from January 1, 2026, through December 31, 2028, with potential renewal for up to three additional years subject to satisfactory performance and funding availability. The contract type is classified as a Master Agreement with a maximum contract value of $48,103,144.50, contingent upon annual legislative appropriation. UnitedHealthcare is required to maintain a performance bond of $4,810,314.45 and must comply with comprehensive federal and state regulatory requirements, including HIPAA regulations, background screening protocols, civil rights compliance, and extensive auditing and monitoring provisions.