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

The Master Agreement FP139 provides a comprehensive Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) designed to deliver coordinated care services to individuals eligible for both Medicare and Medicaid throughout Florida. Under this Fully Integrated Dual Eligible (FIDE) Special Needs Plan, beneficiaries receive access to extensive Medicaid-covered services including behavioral health services, long-term support and services, home health care, and medical supplies and equipment. The contract authorizes service delivery across nine service regions (Regions A-I) spanning 26 counties throughout the state, with multiple benefit package options designated as "Simply Complete" and "Simply Integrated" plans tailored to various dual-eligible categories including QMB, QMB Plus, SLMB, SLMB Plus, QI, QDWI, and FBDE beneficiaries. The plan emphasizes coordinated care management, provider network maintenance, and aligned enrollment for integrated Medicare and Medicaid services.

Simply Healthcare Plans Inc., headquartered in Miami, Florida, serves as the prime contractor for this Master Agreement with the Florida Agency for Health Care Administration (AHCA). The contract period of performance extends from January 1, 2026, through December 31, 2028, with options to renew for up to three additional years upon satisfactory performance evaluation and fund availability. The total contract value is not to exceed $47,447,391.85, subject to annual legislative appropriations, with an associated performance bond requirement of $4,744,739.18. Final contract rates are pending Centers for Medicare & Medicaid Services (CMS) approval for the 2026 contract year.