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

This Master Agreement establishes a Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) vehicle providing coordinated healthcare services to dually eligible beneficiaries across Florida. The IDV enables the delivery of integrated Medicare and Medicaid services through a Fully Integrated Dual Eligible (FIDE) Special Needs Plan structure, encompassing behavioral health services, long-term support and services, home health services, and Medicare cost-sharing coordination. The contract authorizes coverage across nine service regions (Regions A through I), including counties such as Brevard, Broward, Charlotte, Collier, Hillsborough, Lee, Orange, Osceola, Palm Beach, Pinellas, Polk, and Volusia. Two benefit packages are available under this vehicle: Plan Benefit Package 017 (Optimum Emerald Full) for full dual eligible beneficiaries and Plan Benefit Package 016 (Optimum Emerald Partial) for partial dual eligible beneficiaries, with services designed to coordinate aligned Medicare and Medicaid benefits for eligible populations.

Optimum Healthcare Inc. serves as the prime contractor for this Master Agreement, with the Agency for Health Care Administration (AHCA) acting as the contracting organization. The contract period runs from January 1, 2026, through December 31, 2028, with renewal options not to exceed three years or the original contract term, subject to satisfactory performance and fund availability. The total contract value is not to exceed $5,693,017.33, subject to annual appropriations by the Florida Legislature, with a required performance bond of $569,301.73. This statewide vehicle covers the entire state of Florida and operates as a Master Agreement contract type, establishing standardized terms and conditions for the provision of coordinated dual eligible services across authorized jurisdictions.