Medicare Advantage

Does Your Medicaid Status Let You Join a D-SNP?

For 2027, Durham is looking at 69 Medicare Advantage plans: 6 new, 11 gone since 2026, and 25 still here but changed on premium, deductible, plan type or name, 9 of them under a new name. Below, how the lineup shifted in Durham County and what to compare, with no plan ranked or recommended.

Durham, N.C. — Fall 2026. If you have both Medicare and North Carolina Medicaid, you have a specific kind of plan built for you: a Dual Special Needs Plan, or D-SNP. For 2027, Durham County residents will be able to choose from 20 D-SNPs offered by eight carriers, according to the CMS Medicare Advantage Landscape Source File. The Annual Enrollment Period runs October 15 through December 7, 2026, and any choice you make takes effect January 1, 2027.

Here is what dual-eligible readers in Durham should know before picking a plan — including who qualifies, how often you can switch, and how to confirm your Medicaid status.

What is a D-SNP, and who qualifies in Durham?

A Dual Special Needs Plan is a type of Medicare Advantage plan designed only for people who have both Medicare and Medicaid. To qualify, you must be enrolled in Medicare (Parts A and B) and also receive some level of help from North Carolina Medicaid.

There are two broad categories of dual eligibility:

• Full dual eligibility means Medicaid pays your Medicare premiums and cost-sharing and also covers additional services (like long-term care) that Medicare does not.
• Partial dual eligibility means Medicaid helps with some Medicare costs — for example, through the Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), or Qualifying Individual (QI) programs — but you may not get the full Medicaid benefit package.

Different D-SNPs are designed for different levels of dual eligibility. Your category decides which plans you can join, so this is the first thing to confirm.

How do I confirm my Medicare and Medicaid eligibility?

Start by checking both sides separately. For Medicare, call 1-800-MEDICARE (1-800-633-4227) or sign in at medicare.gov to see your current coverage. For Medicaid, contact NC Medicaid through the North Carolina Department of Health and Human Services, or call your local Durham County Department of Social Services, which handles Medicaid applications and renewals for residents.

Your Medicaid category (full dual, QMB, SLMB, QI, and so on) appears on your eligibility notice from the state. Bring that information with you — or have it on hand — when you compare D-SNPs, because enrollment staff will ask.

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

Durham is in Durham County, where 20 D-SNPs will be offered for 2027 out of 69 Medicare Advantage plans overall. The county also has 3 Chronic Condition SNPs (C-SNPs) and 5 Institutional SNPs (I-SNPs) for people who meet those specific criteria.

The eight carriers offering D-SNPs in Durham County for 2027 are:

• Aetna (CVS Health) — 2 D-SNPs
• Blue Cross and Blue Shield of North Carolina — 1 D-SNP
• Centene (WellCare) — 3 D-SNPs
• HealthSpring — 2 D-SNPs
• Humana — 5 D-SNPs
• Liberty Medicare Advantage — 1 D-SNP
• Troy Medicare — 1 D-SNP
• UnitedHealthcare — 5 D-SNPs

Two of the UnitedHealthcare D-SNPs — UHC Dual Complete NC-Q2 (HMO-POS D-SNP) and UHC Dual Complete NC-S3 (HMO-POS D-SNP) — are new for 2027. Several plans have been renamed for 2027, including Aetna Medicare Full Dual (HMO D-SNP), the three Wellcare Carolina Complete Dual plans, UHC Dual Advantage NC-V1 (HMO-POS D-SNP), and UHC Dual Complete NC-Q1 (PPO D-SNP). A rename does not change the plan's contract, but the Annual Notice of Change (ANOC) will show whatever benefits or costs have been adjusted. The table below lists every D-SNP available in the county.

How often can a dual-eligible person change plans?

Unlike most Medicare beneficiaries, people with Medicaid or Extra Help are not limited to the October 15–December 7 window. Under current rules, dual-eligible beneficiaries have a monthly Special Enrollment Period that lets them either:

• Join or switch to an integrated D-SNP, or
• Leave a Medicare Advantage plan and return to Original Medicare with a stand-alone Part D drug plan.

That means if your situation changes mid-year — a move, a new diagnosis, a change in your Medicaid status — you often have an opportunity to adjust your coverage without waiting for fall. These rules have shifted in recent years and will keep evolving, so always confirm the current Special Enrollment Period rules with 1-800-MEDICARE before you act.

If you do nothing during the Annual Enrollment Period, your current plan simply renews for 2027 if it is still offered, with the changes described in its ANOC.

What else is changing for 2027?

A few program-level numbers are already set. For Part D drug coverage, the out-of-pocket cap rises to $2,400 in 2027 (up from $2,100 in 2026), and the maximum Part D deductible is $700 in 2027 (up from $615 in 2026). Many D-SNP members get help with these costs through Medicaid or Extra Help, but it is useful to know the limits.

The 2027 Part B premium and deductible, and the 2027 IRMAA income brackets, have not been announced yet. CMS typically publishes those in the fall, usually in November.

Countywide, 11 Medicare Advantage plans are not returning for 2027, 6 are new, and 9 have been renamed. If your plan is leaving, you will get a non-renewal letter and a Special Enrollment Period to choose a replacement.

How should I compare D-SNPs in Durham?

Because every D-SNP works a little differently, these are the questions worth answering before you enroll:

• Does the plan match my level of dual eligibility (full or partial)?
• Are my doctors, specialists, and preferred hospitals in the network?
• Are my prescriptions on the plan's drug list, and at which pharmacies?
• Does the plan coordinate my Medicare and Medicaid benefits in one package (an integrated D-SNP)?

Plan-specific details — benefits, copays, provider networks, drug formularies, and star ratings — come from the official sources: the Medicare Plan Finder at medicare.gov, 1-800-MEDICARE, or the plan's own Evidence of Coverage and provider/pharmacy directories.