Medicare Advantage

Medicare and Medicaid in New York City: a guide to the 27 D-SNPs for 2027

New York County has 61 Medicare Advantage plans for 2027. Compared with 2026, 20 plans are not coming back, 6 are new, and 13 continuing plans changed in some way you should check before December 7, 2 of them under a new name. This guide covers what those numbers mean for New York City, not which plan to pick.

NEW YORK CITY — If you have both Medicare and Medicaid and live in New York City, your 2027 choices are coming into focus. The federal government's 2027 plan data shows 27 Dual Special Needs Plans (D-SNPs) will be offered in New York County, the county New York City is in, from 13 carriers. The Annual Enrollment Period runs October 15 through December 7, 2026, and a change made during that window takes effect January 1, 2027.

Dual Special Needs Plans are a type of Medicare Advantage plan built for people who qualify for both Medicare and Medicaid. They coordinate the two programs under one plan and always include drug coverage. If you are "dual eligible," you also have more freedom than most people to change plans during the year — a point we'll come back to below.

What a D-SNP is, in plain terms

A D-SNP is a Medicare Advantage plan limited to people who have Medicare and Medicaid at the same time. Because Medicaid picks up costs that Medicare does not, D-SNPs are designed to work with your Medicaid benefits rather than duplicate them. All D-SNPs in New York County include Part D prescription drug coverage.

Some D-SNPs are "fully integrated," meaning the same company manages your Medicare and your Medicaid long-term services and supports under one plan. Others coordinate with Medicaid without combining it. The plan's name sometimes hints at the design — words like "Full Dual," "LTSS," "MAP," or "Total" point to more integrated models — but the Evidence of Coverage is where the real detail lives.

Who qualifies: full vs. partial dual eligibility

Dual eligibility is not one single status. New York State's Medicaid agency decides which category you fall into, based on your income, resources and situation:

• Full dual eligible: You get full New York Medicaid benefits along with Medicare. Medicaid helps with Medicare premiums and cost sharing, and also covers services Medicare doesn't, such as long-term care.
• Partial dual eligible: You qualify for a Medicare Savings Program (such as QMB, SLMB or QI) that helps pay some Medicare costs, but you don't have full Medicaid benefits.

Different D-SNPs are built for different groups. Some accept only full duals; some are open to partial duals; some are specifically for people who need nursing-home level care. The plan materials will say who it's for, and the Medicare Plan Finder at medicare.gov will only show you plans you can actually join once you enter your ZIP code and Medicaid status.

To confirm your Medicaid level, contact the New York State Department of Health or your local Human Resources Administration office. To confirm what Medicare sees, call 1-800-MEDICARE (1-800-633-4227).

The 27 D-SNPs offered in New York County for 2027

Carriers offering D-SNPs in the county next year, with the number of D-SNPs each has:

• Aetna (CVS Health) — 1
• Centene (WellCare) — 3
• Elderplan — 2
• ElderServe Health — 1
• Elevance Health (Anthem) — 2
• Hamaspik, Inc. — 2
• Healthfirst Medicare Plan — 3
• Humana — 1
• MetroPlus Health Plan — 2
• Senior Whole Health of New York — 2
• UnitedHealthcare — 4
• VillageCareMAX — 2
• VNS Health Medicare — 2

The table below lists every D-SNP by name. A few notes from the 2027 data worth knowing before you compare:

• New for 2027: Wellcare Fidelis Dual Access (HMO D-SNP), Wellcare Fidelis Dual Liberty Sync (HMO D-SNP), Humana Gold Plus SNP-DE H3533-036 (HMO D-SNP), and UHC Dual Complete NY-S002 (HMO-POS D-SNP).
• Renamed for 2027: Wellcare Fidelis Dual Align Unity (HMO D-SNP) was previously Wellcare Fidelis Dual Align; UHC Dual Complete NY-YL (HMO-POS D-SNP) was previously UHC Dual Complete NY-Y001.

A rename doesn't automatically mean your coverage changes — check your ANOC to see what, if anything, is different.

How often a dual-eligible person can change plans

Most people with Medicare can only switch plans during the Annual Enrollment Period (October 15 – December 7) or the Medicare Advantage Open Enrollment Period (January 1 – March 31). People with Medicaid or Extra Help have more flexibility.

In general, dual-eligible members get a monthly Special Enrollment Period to make certain changes — such as joining an integrated D-SNP that matches their Medicaid plan, or dropping a Medicare Advantage plan to go back to Original Medicare with a stand-alone Part D plan. The specific rules were tightened in recent years and continue to be refined, so instead of relying on what used to be true, call 1-800-MEDICARE or use medicare.gov to see which SEPs apply to you this month.

If you lose Medicaid, there's also a grace period to find new coverage. Your current D-SNP will usually keep you enrolled for a limited time while your eligibility is sorted out, and will send a notice explaining your options.

How to confirm your eligibility and compare

A few steady steps make this manageable:

1. Confirm your Medicaid level with New York State. Ask whether you are full dual or partial dual, and whether you are enrolled in any Medicaid managed long-term care plan. 2. Confirm your Medicare status at medicare.gov or by calling 1-800-MEDICARE. 3. Compare D-SNPs on the Medicare Plan Finder (medicare.gov/plan-compare). Enter your ZIP code, your drugs and your pharmacies. The Plan Finder will show only the plans you're eligible to join and will reflect your Medicaid cost-sharing help. 4. Read the ANOC your current plan sent you in September 2026. It explains every change coming January 1, 2027. 5. Check doctors and drugs against each plan's directory and formulary before you decide.

A couple of 2027 program facts worth knowing

Even inside a D-SNP, drug coverage follows Part D rules. For 2027, CMS has confirmed the Part D out-of-pocket cap will be $2,400 (up from $2,100 in 2026) and the maximum Part D deductible will be $700 (up from $615 in 2026). Many dual-eligible members pay far less because of Extra Help and Medicaid, but these are the ceilings that frame the program.

The 2027 Part B standard premium and deductible, and the 2027 IRMAA income brackets, had not been announced as of early fall 2026; CMS typically publishes them in November.