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) designed to serve dual-eligible beneficiaries across Florida. The IDV encompasses coordinated delivery of integrated Medicare and Medicaid benefits through a Highly Integrated Dual Eligible (HIDE) Special Needs Plan model. Covered services include emergency services, prescribed drugs, behavioral health services, clinic services through Rural Health Clinics and Federally Qualified Health Centers, home health, durable medical equipment, nursing facility services, and transportation. The contract authorizes multiple Plan Benefit Packages (PBPs) serving various Medicaid eligibility categories including Qualified Medicare Beneficiaries (QMB), Specified Low-Income Medicare Beneficiaries (SLMB), and Full Benefit Dual Eligible (FBDE) individuals across nine authorized service regions (Regions A through I) throughout Florida.

Aetna Health Inc. serves as the prime contractor under this Master Agreement with the Agency for Health Care Administration (AHCA). The contract is effective January 1, 2026, through December 31, 2028, with renewal options available for up to three additional years, subject to satisfactory performance and fund availability. The contract covers statewide service throughout Florida and is structured as a Master Agreement with a total contract value not to exceed $91,595,241.61, contingent upon annual legislative appropriation. Aetna is assigned Medicaid Provider Identification Number 103360000 and operates under federal CMS contract number H1609, with a required performance bond of $9,159,524.16.