Medicare Advantage

Medicare and Medicaid in New Jersey: 5 Dual Special Needs Plans for 2027

TRENTON, N.J. — New Jerseyans who have both Medicare and Medicaid will have five Dual Special Needs Plans (D-SNPs) to consider for the 2027 plan year, according to the Centers for Medicare & Medicaid Services Medicare Advantage Landscape Source Files for CY2027. The five D-SNPs are a subset of the 71 Medicare Advantage plans counted statewide in New Jersey for 2027. Alongside them, CMS data show 7 Chronic Condition Special Needs Plans (C-SNPs) and 3 Institutional Special Needs Plans (I-SNPs) in the state.

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Enrollment choices made during the Annual Enrollment Period, which runs October 15 through December 7, 2026, take effect January 1, 2027.

What a D-SNP is and who qualifies

A Dual Special Needs Plan is a type of Medicare Advantage plan designed specifically for people who are enrolled in both Medicare and Medicaid. The "dual" in the name refers to that dual enrollment. These plans coordinate the Medicare side of a person's coverage with the Medicaid benefits they already receive through the state.

Dual eligibility comes in two broad forms. "Full" dual eligibles qualify for the full package of Medicaid benefits in addition to Medicare. "Partial" dual eligibles qualify for help from Medicaid with certain Medicare costs through one of the Medicare Savings Programs, but not for full Medicaid benefits. Both groups may be able to enroll in a D-SNP, though specific plans can be designed for specific dual-eligibility categories.

Eligibility for Medicaid, and the category a person falls into, is confirmed by the state Medicaid agency — in New Jersey, that is NJ FamilyCare / New Jersey Medicaid. A D-SNP cannot verify Medicaid status on its own; the state's determination is what counts.

The statewide count and the carriers offering them

For 2027, CMS's Landscape files list 5 D-SNPs available somewhere in New Jersey, offered by five carriers. In alphabetical order by carrier, those plans are:

• Aetna Medicare FIDE (HMO D-SNP), from Aetna (CVS Health)
• Wellcare Fidelis Dual Align (HMO D-SNP), from Centene (WellCare)
• Wellpoint Full Dual Advantage (HMO D-SNP), from Elevance Health (Anthem)
• Horizon NJ TotalCare (HMO D-SNP), from Horizon Blue Cross Blue Shield of New Jersey
• UHC Dual Complete NJ-Y001 (HMO D-SNP), from UnitedHealthcare

All five are HMO D-SNPs that include drug coverage. The county-level availability shown in the CMS files ranges across 20 to 21 of New Jersey's 21 counties, depending on the plan. The full plan and carrier tables are rendered elsewhere on this page from the same CMS data; the names above are the same ones that appear there.

A plan being listed statewide does not mean it is sold in every county. Each D-SNP is offered county by county, so a reader in, say, Cape May should confirm which of the five plans is actually available at their address before comparing anything else.

How often a dual-eligible person can change plans

People who have both Medicare and Medicaid have more flexibility than most Medicare beneficiaries when it comes to changing plans.

Every Medicare beneficiary can use the Annual Enrollment Period, October 15 through December 7, 2026, to join, switch, or drop a Medicare Advantage or Part D plan for 2027. Choices made during that window take effect January 1, 2027.

In addition, dual-eligible individuals and others who qualify for Extra Help with their Part D drug costs generally have a Special Enrollment Period that lets them make a change once per calendar quarter during the first three quarters of the year (January–March, April–June, and July–September). Changes in the fourth quarter are typically made through the Annual Enrollment Period itself.

There is also a separate Medicare Advantage Open Enrollment Period from January 1 through March 31, 2027, when someone already in a Medicare Advantage plan can make one change.

Enrollment windows and rules are described on medicare.gov under Medicare enrollment periods, and a representative at 1-800-MEDICARE can walk through which window applies to a particular situation.

Checking a plan in your county

Because D-SNP availability is county by county, the most reliable way to see what is offered at a specific address is the Medicare Plan Finder at medicare.gov. Entering a ZIP code returns the Medicare Advantage and Part D plans available there for the selected plan year, including D-SNPs for those who qualify.

For the detail that matters most to a household — the monthly premium, deductibles, copays, covered drugs, provider and pharmacy networks, extra benefits, and star ratings — the authoritative sources are the Medicare Plan Finder, 1-800-MEDICARE, and each plan's own Evidence of Coverage and provider and pharmacy directories. Those documents, not summary articles, are what a person should rely on before enrolling.

It is worth comparing the 2027 Landscape against the 2026 one as well, since CMS publishes both the current and coming plan year files. Plans and service areas can shift from year to year, and a plan available in a county in 2026 may or may not be available there in 2027.

Free help

Free help is available for New Jerseyans sorting through their options. Medicare.gov offers side-by-side plan comparisons, drug cost estimates, and plan documents. 1-800-MEDICARE (TTY 1-877-486-2048) is staffed 24 hours a day, seven days a week, and representatives can answer questions in English and other languages.

For the Medicaid side of the equation — confirming full or partial dual-eligibility status, or applying — the state Medicaid agency, NJ FamilyCare, is the authoritative source.