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

This Master Agreement establishes a Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) that provides comprehensive coordinated care services to individuals eligible for both Medicare and Medicaid in Florida. The plan delivers integrated medical, behavioral health, acute care, primary care, home health, and prescription drug services across multiple service regions, including Miami-Dade, Broward, Hillsborough, Pasco, Polk, Orange, Seminole, and Osceola counties. Doctors HealthCare Plans, Inc. operates three distinct plan offerings—DrFlex, DrPlus, and DrPlatinum-CFL—as a Fully Integrated Dual Eligible (FIDE) Special Needs Plan, providing aligned Medicare and Medicaid benefits under a single entity. The plan covers various eligible populations including Qualified Medicare Beneficiaries (QMB), Specified Low-Income Medicare Beneficiaries (SLMB), Qualifying Individuals (QI), and Full Benefit Dual Eligible (FBDE) recipients, with services encompassing care management, enrollee transitions between care settings, and comprehensive compliance with federal and state regulatory requirements.

The prime contractor for this Master Agreement is Doctors HealthCare Plans, Inc., based in Coral Gables, Florida, contracting with the State of Florida Agency for Health Care Administration (AHCA). The contract is designated as AHCA Contract No. FP150 and runs from January 1, 2026, through December 31, 2028, with options for renewal for up to three additional years contingent upon satisfactory performance and legislative appropriation. The contract type is a Master Agreement with a total contract value not to exceed $13,244,708.27, with capitated rates determined by the Centers for Medicare & Medicaid Services (CMS) and subject to AHCA approval. The vendor is required to maintain a performance bond of $1,324,470.83 and operates under Medicaid Provider Identification Number 102626200 across all authorized Florida service areas.