Short answer: A full-benefit dual can join or switch to an integrated D-SNP once per calendar month, to line up with their Medicaid managed care plan. Not every D-SNP is integrated, and partial duals don’t get this window.
Since 2025, 42 CFR 423.38(c)(35) gives full-benefit dual eligibles a once-per-month election into a fully integrated D-SNP (FIDE SNP), a highly integrated D-SNP (HIDE SNP) or an applicable integrated plan, available only to align the person’s Medicare plan with their Medicaid plan. The change takes effect the first day of the next month.
Medicare.gov says every integrated D-SNP must give the member one ID card for Medicare and Medicaid, one health risk assessment, a care coordinator and personal care plan, and one appeals and grievance process. Not all D-SNPs are integrated; ask the plan, or call 1-800-MEDICARE for a list of integrated D-SNPs in the area.
CMS’s stated aim was to steer dual eligibles into Medicare plans run by the same organization as their Medicaid plan and to reduce marketing to duals outside the annual election period. In Texas, full-benefit duals’ Medicaid generally runs through STAR+PLUS, so check which STAR+PLUS plan you have before choosing a D-SNP.