Medicare Advantage

Do You Have Both Medicare and Medicaid in Bernalillo?

People in Albuquerque can choose from 36 Medicare Advantage plans for 2027, against 51 this year. 24 of this year’s plans are gone, 9 are new to Bernalillo County, and 22 that continue have changed their premium, deductible, plan type or name, 9 of them under a new name.

ALBUQUERQUE — Fall 2026 is Medicare's annual sorting season, and for people who have both Medicare and Medicaid in Bernalillo County, the choices for 2027 look a little different. Four insurers plan to offer Dual Special Needs Plans (D-SNPs) here next year, and most of those plans are either new or renamed on the CMS lineup — a reason to read the mail that arrives this fall rather than assume everything is the same.

D-SNPs are a type of Medicare Advantage plan built for people who qualify for both programs. If that's your situation, this guide walks through what's on the shelf for Bernalillo County in 2027, who qualifies, how often you can switch, and how to confirm your eligibility.

What a D-SNP is, in plain English

A Dual Special Needs Plan is a Medicare Advantage plan limited to people who have both Medicare and Medicaid. It bundles your Part A (hospital), Part B (medical) and Part D (drug) coverage into one plan and is designed to work alongside your Medicaid benefits, so the two programs talk to each other instead of leaving you in the middle.

All D-SNPs include prescription drug coverage. The specifics — what doctors are in network, what the plan covers beyond Original Medicare, what you pay at the pharmacy — vary by plan and are laid out in each plan's Evidence of Coverage. For personalized details, use the Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

The 2027 D-SNP lineup in Bernalillo County

Albuquerque is in Bernalillo County, where Medicare plan availability is set. For 2027, CMS lists 7 D-SNPs in the county from 4 carriers. The table below lists every plan; here they are by carrier, in alphabetical order:

• Blue Cross Blue Shield (HCSC) — 2 D-SNPs: Blue Cross Medicare Advantage Dual Care (HMO-POS D-SNP), new for 2027; Blue Cross Medicare Advantage Dual Care Plus (HMO-POS D-SNP), new for 2027.
• Molina Healthcare of New Mexico — 1 D-SNP: Molina Medicare Complete Care (HMO D-SNP), new for 2027.
• Presbyterian Health Plan — 1 D-SNP: Presbyterian Dual Plus (HMO D-SNP).
• UnitedHealthcare — 3 D-SNPs: UHC Dual Advantage NM-V1 (PPO D-SNP), renamed (was UHC Dual Complete NM-V1); UHC Dual Complete NM-Q1 (PPO D-SNP), renamed (was UHC Dual Complete NM-S1); UHC Dual Complete NM-S2 (PPO D-SNP), new for 2027.

Several of these are either brand-new on the CMS lineup for 2027 or carry a new name even though the plan continues. If you're already enrolled, your plan's Annual Notice of Change (ANOC), mailed by the end of September, spells out what is changing for your specific plan on Jan. 1, 2027.

For context, Bernalillo County also has 8 Chronic Condition Special Needs Plans (C-SNPs) in 2027 for people with qualifying conditions like diabetes or heart disease, and no Institutional SNPs (I-SNPs). Those are separate from D-SNPs and have their own eligibility rules.

Who qualifies: full vs. partial dual eligibility

To join any D-SNP, you need Medicare (Parts A and B) and some form of Medicaid help. In New Mexico, Medicaid is run through the Turquoise Care program.

Dual eligibility comes in two broad flavors:

• Full dual eligible. You have Medicare and full New Mexico Medicaid benefits. Medicaid typically helps pay your Medicare premiums and cost-sharing, and also covers services Medicare does not, like long-term services and supports.
• Partial dual eligible. You qualify for one of the Medicare Savings Programs (QMB, SLMB or QI), which help pay some Medicare costs, but you don't have full Medicaid benefits.

Different D-SNPs are built for different subgroups — some accept only full duals, others accept partial duals as well. The New Mexico Human Services Department (which runs Medicaid) is the office that confirms your category, and the plan will verify that category before enrolling you.

How often you can change plans

Most people with Medicare can change Medicare Advantage or Part D plans only during set windows:

• Annual Enrollment Period: Oct. 15 – Dec. 7, 2026, for coverage that starts Jan. 1, 2027.
• Medicare Advantage Open Enrollment Period: Jan. 1 – March 31, 2027, for people already in a Medicare Advantage plan to switch once.

Dual eligibles and people who get Extra Help with drug costs get additional chances to change during the year. In general, there is a monthly opportunity to enroll in an integrated D-SNP, or to leave a Medicare Advantage plan and go back to Original Medicare with a stand-alone Part D plan. The exact rules have been tightening in recent years, so before you act, call 1-800-MEDICARE (TTY 1-877-486-2048) or check medicare.gov to confirm what applies to your situation right now.

Doing nothing is also a choice: if your current plan is offered again in 2027, you stay in it automatically, with whatever changes the ANOC describes.

How to confirm your eligibility

Three straightforward ways to pin down where you stand:

1. Check your Medicaid status with New Mexico. The Human Services Department can tell you whether you have full Medicaid, a Medicare Savings Program, or neither. Their YES New Mexico portal (yes.state.nm.us) shows your current case. 2. Check your Medicare status. Create or sign in to your account at medicare.gov to see your Part A, Part B and Part D enrollment, plus whether you have Extra Help. 3. Call 1-800-MEDICARE. A representative can confirm your dual-eligible category, your current special enrollment rights, and which D-SNPs in Bernalillo County are accepting your category.

Plans themselves will also verify your eligibility when you apply; they are not allowed to enroll you in a D-SNP if your Medicaid status doesn't match the plan's rules.

A few 2027 numbers worth knowing

Even though D-SNPs often cover drug costs differently than a stand-alone Part D plan, the program-level 2027 figures are useful background:

• Part D out-of-pocket cap: $2,400 in 2027 (up from $2,100 in 2026).
• Part D maximum deductible: $700 in 2027 (up from $615 in 2026).
• Part B premium and deductible for 2027: not yet announced; CMS typically publishes these in November.
• IRMAA income brackets for 2027: also not yet announced.

People with full Medicaid or Extra Help usually pay little or nothing at the pharmacy counter, but the caps above are what the broader Part D program is working toward.