Medicare Advantage

Hialeah's 2027 Dual Special Needs Plans: how often you can switch if you have Medicare and Medicaid

People in Hialeah can choose from 101 Medicare Advantage plans for 2027, against 115 this year. 30 of this year’s plans are gone, 16 are new to Miami-dade County, and 61 that continue have changed their premium, deductible, plan type or name, 20 of them under a new name.

HIALEAH, Fla. — Fall 2026. If you live in Hialeah and have both Medicare and Medicaid, Miami-Dade County will offer 34 Dual Special Needs Plans (D-SNPs) for 2027, from 11 carriers. That is one slice of the local Medicare Advantage lineup, and it comes with its own set of rules — including more chances to change your plan than most people get.

The Annual Enrollment Period runs October 15 through December 7, 2026, and any change you make then starts January 1, 2027. But for dual-eligible residents, the calendar is more flexible, and the plan choices are built around the fact that Medicaid picks up costs Medicare does not.

What is a Dual Special Needs Plan, and who qualifies in Hialeah?

A D-SNP is a type of Medicare Advantage plan built for people who have both Medicare and Medicaid. To join, you must be entitled to Medicare Part A, enrolled in Part B, and receiving some level of Medicaid help from the state of Florida.

Florida Medicaid decides what level of help you qualify for. "Full dual" means Medicaid covers your Medicare cost sharing and also pays for benefits Medicare does not, like long-term services and supports. "Partial dual" categories — the most common is the Qualified Medicare Beneficiary (QMB) program — mean Medicaid pays your Medicare premiums and cost sharing, but you do not get full Medicaid benefits. Each D-SNP is designed for a specific group, so the plan you can enroll in depends on which category you are in.

How many D-SNPs are offered in Miami-Dade County for 2027?

For 2027, Miami-Dade County has 34 D-SNPs out of 101 Medicare Advantage plans, along with 20 Chronic Condition SNPs (C-SNPs) and 6 Institutional SNPs (I-SNPs). The table below lists every D-SNP by carrier.

Eleven carriers offer D-SNPs in the county for 2027: Aetna (CVS Health), AmeriHealth Caritas VIP Care, Centene (WellCare), Devoted Health, Doctors HealthCare Plans, Elevance Health (Anthem), Florida Complete Care, Humana, Leon Health, Solis Health Plans, and UnitedHealthcare. Several D-SNPs are new for 2027 — including an Aetna Medicare Partial Dual Select plan, three new Wellcare Sunshine Health dual plans, a new Simply Complete Platinum plan from Elevance Health, a new Humana Dual Integrated PPO, and a new DrPartialDual-SFL plan from Doctors HealthCare Plans. Several others have been renamed; the Annual Notice of Change your plan mails each fall spells out what changed.

How often can a dual-eligible person in Hialeah change plans?

Most Medicare beneficiaries can only change their Medicare Advantage or drug plan during the fall Annual Enrollment Period (October 15 – December 7) or the Medicare Advantage Open Enrollment Period (January 1 – March 31). People with Medicaid or Extra Help get an additional Special Enrollment Period that works monthly.

Under current rules, a dual-eligible resident of Hialeah has a monthly opportunity to enroll in an integrated D-SNP that works closely with their Medicaid plan, or to leave Medicare Advantage and return to Original Medicare paired with a stand-alone Part D drug plan. Changes made through this monthly window take effect the first day of the following month. The specifics of these Special Enrollment Periods have changed in recent years, so confirm the current rules at 1-800-MEDICARE before you move.

How do I confirm my eligibility before enrolling?

Start with two phone calls. For your Medicaid level, contact the Florida Department of Children and Families or your current Medicaid managed care plan; they can confirm whether you are full dual, QMB, or in another partial dual category. For your Medicare status and plan options, call 1-800-MEDICARE (24 hours a day, 7 days a week) or sign in at medicare.gov.

The Plan Finder at medicare.gov lets you enter your ZIP code and your medications, and it will show only the D-SNPs you are eligible for based on the Medicaid information on file. If your Medicaid category changes later — for example, if your income drops and you move from QMB to full dual — you may become eligible for a different D-SNP, and that change itself opens a Special Enrollment Period.

What else should Hialeah residents know for 2027?

A few program-level numbers are already set. The Part D out-of-pocket cap is $2,400 in 2027 (up from $2,100 in 2026), and the Part D maximum deductible is $700 in 2027 (up from $615 in 2026). If you qualify for full Medicaid or Extra Help, those caps and deductibles usually do not apply to you the way they do to other members — your drug costs are set by the Extra Help program instead.

The 2027 Part B standard premium and deductible, and the 2027 IRMAA income brackets, have not yet been announced. CMS normally publishes them in the fall. If you do nothing during Annual Enrollment, your current plan renews for 2027 if it is still offered, with the changes listed in its Annual Notice of Change.