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Who can use the Integrated Care SEP?
The Integrated Care SEP lets a full-benefit dually eligible individual (QMB+, SLMB+, or FBDE level Medicaid) enroll in an integrated D-SNP in any month, to align their Medicare and Medicaid coverage with the same organization.
Full-benefit dually eligible individuals — QMB+, SLMB+, or FBDE level Medicaid. Partial-benefit duals and LIS-only individuals use the separate Dual/LIS SEP instead.
Aligning enrollment with an integrated D-SNP (FIDE, HIDE, or AIP) and its companion Medicaid managed care organization, so both plans are coordinated under the same parent organization.
Non-AIP integrated D-SNPs can only use this SEP to align enrollment to an affiliated Medicaid MCO. AIP D-SNPs generally have broader alignment flexibility — always verify current CMS guidance for the specific plan.
FIDE / HIDE / CO / AIP — quick legend
States with confirmed AIP D-SNP programs
Per CMS's current AIP D-SNP model materials list: