Medicare Advantage

Medicare and Medicaid together in Pittsburgh: your 2027 D-SNP options in Allegheny County

People in Pittsburgh can choose from 95 Medicare Advantage plans for 2027, against 96 this year. Nine of this year’s plans are gone, 8 are new to Allegheny County, and 46 that continue have changed their premium, deductible, plan type or name, 11 of them under a new name.

PITTSBURGH — Nov. 2026. If you have both Medicare and Medicaid and live in or near Pittsburgh, your 2027 coverage choices are coming into focus. Allegheny County will have 20 Dual Special Needs Plans (D-SNPs) available for the plan year that starts January 1, 2027, offered by 11 carriers. A few plans have been renamed, and two are brand new, so this is a good season to open your mail and read what came from your current plan.

D-SNPs 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 they include Part D drug coverage. Below is what Pittsburgh-area readers tell us they most want to know: who qualifies, how often you can switch, and how to confirm your Medicaid level with the state.

Which D-SNPs are offered in Pittsburgh for 2027?

Allegheny County has 20 Dual Special Needs Plans available for 2027, offered by 11 carriers. That is part of a wider local lineup that also includes 7 Chronic Condition SNPs (C-SNPs) and 8 Institutional SNPs (I-SNPs), alongside general Medicare Advantage plans.

The D-SNP carriers for 2027 are Aetna (CVS Health) with 2 plans, Centene (WellCare) with 2, Devoted Health with 2, Geisinger Gold with 1, HealthSpring with 1, Highmark Wholecare Medicare Assured with 2, Humana with 2, Jefferson Health Plans with 2, UnitedHealthcare with 4, UPMC for Life Complete Care with 1, and VISTA Health Plan Inc. with 1. The full plan-by-plan table below this article lists every D-SNP by name.

Two D-SNPs are new for 2027 in the county: Aetna Medicare Full Dual Extra (HMO D-SNP) and UPMC for Life Complete Care (HMO D-SNP). Several familiar plans have been renamed — Aetna Medicare Dual (HMO D-SNP) was previously Aetna Medicare Advantra Dual; the two Wellcare plans added "PA Health & Wellness" to their names; and UHC Dual Advantage PA-V1 was previously UHC Dual Complete PA-V001. The plans themselves are still being offered — only the names changed. Your plan's Annual Notice of Change (ANOC) has the specifics.

Who qualifies for a Dual Special Needs Plan in Pennsylvania?

To join a D-SNP, you need both Medicare (Parts A and B) and some level of Pennsylvania Medicaid. Pennsylvania's Department of Human Services is the agency that confirms what level of Medicaid you have, and that level is what decides which D-SNPs you can join.

In plain terms, there are two broad groups:

• Full dual-eligible. You have full Medicaid benefits in addition to Medicare. Medicaid usually helps with Medicare premiums and cost-sharing, and also covers services Medicare does not, like long-term services and supports.
• Partial dual-eligible. You get help from a Medicare Savings Program (such as QMB, SLMB, or QI) that pays some Medicare costs, but you do not have full Medicaid benefits.

Some D-SNPs are designed for full duals only; others accept a broader mix. Your Medicaid category decides your options, which is why confirming it before you enroll matters.

How often can a dual-eligible person change plans?

People with Medicaid or Extra Help have more chances to change plans than most Medicare members. In addition to the fall Annual Enrollment Period (October 15 – December 7, 2026) and the Medicare Advantage Open Enrollment Period (January 1 – March 31, 2027), dual-eligible members generally have a monthly Special Enrollment Period that lets them either join an integrated D-SNP or move back to Original Medicare with a stand-alone Part D plan.

CMS has been tightening the rules on how often and when dual-eligibles can switch, and the exact rules depend on the type of plan and your Medicaid status. Before you make a change, call 1-800-MEDICARE (TTY 1-877-486-2048) to confirm which Special Enrollment Period applies to you right now.

How do I confirm my Medicaid eligibility for a D-SNP?

Three steps work for most Pittsburgh-area readers:

1. Check with Pennsylvania Medicaid. Call the state's Department of Human Services or sign in to your COMPASS account to see your current eligibility category. The carrier offering a D-SNP will verify this with the state before enrollment, but it helps to know your category first. 2. Check your Medicare status. You can review your Medicare enrollment at medicare.gov or by calling 1-800-MEDICARE. Make sure Part A and Part B are both active. 3. Match the plan to your category. Use the Medicare Plan Finder at medicare.gov to see which Pittsburgh-area D-SNPs you qualify for based on your ZIP code and dual-eligibility level, or call the plan directly.

If your Medicaid status changes mid-year — for example, you lose full benefits — your D-SNP has a "grace period" to help you keep coverage while things get sorted out. Call your plan and the state right away if you get a notice.

What about program-wide 2027 changes I should know?

A few Medicare-wide changes land January 1, 2027, and they apply to D-SNP members too:

• The Part D out-of-pocket cap rises to $2,400 in 2027 (up from $2,100 in 2026). Once your drug spending hits that cap, you pay $0 for covered Part D drugs the rest of the year.
• The Part D maximum deductible rises to $700 in 2027 (up from $615 in 2026). Many D-SNPs set the deductible lower, and Extra Help may cover it.
• The Part D national base beneficiary premium is $41.33 for 2027. That is a formula input Medicare uses, not what any specific plan charges.
• The 2027 Part B standard premium and deductible and the 2027 IRMAA income brackets have not been published yet. CMS normally announces them later in the fall.

If you take several prescriptions, the Medicare Prescription Payment Plan is also still available in 2027. It lets you spread your Part D drug costs across the calendar year in monthly installments at no extra charge.

What should Pittsburgh dual-eligibles do before December 7, 2026?

Pittsburgh residents choosing coverage for 2027 should read the ANOC their current plan mailed in September, confirm their Medicaid status with Pennsylvania DHS, and compare their D-SNP options on medicare.gov before December 7, 2026. If you do nothing and your current plan is returning in 2027, you stay enrolled with the changes described in the ANOC.

If you want to switch, you can use the Annual Enrollment Period in the fall, the Medicare Advantage Open Enrollment Period from January 1 to March 31, or — if you qualify — the monthly Special Enrollment Period for people with Medicaid or Extra Help.