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2026 Dual Special Needs plan (D-SNP) updates

Changes are here for Dual Special Needs plans


The Centers for Medicare & Medicaid Services (CMS) has made changes to the rules for Dual Special Needs plans (D-SNPs). These changes apply to all insurers — not just UnitedHealthcare — and may affect your D-SNP benefits and when you can sign up for or change your plan. We know it can be hard to understand how to get the most from your coverage, especially when things change. You can count on UnitedHealthcare to provide you with reliable Medicare information and support every step of the way.

What’s changing for D-SNP benefits in 2026?


CMS has ended a program called the Value-Based Insurance Design (VBID) model. Here's what this means for you:

End of $0 copayments for prescriptions
 

With VBID no longer being offered, many Part D plans will no longer be able to offer all covered drugs at $0. Some insurers may still offer savings on prescription drugs through different programs, and members won’t pay more than the copayments (copays) aligned to their level of Extra Help.

New qualifications for supplemental benefits
 

Eligibility for non-medical supplemental benefits, such as a credit for healthy food and home utilities, will be based on verification of a qualifying chronic condition. Conditions may include chronic high blood pressure, diabetes or cardiovascular disease. Check with your plan provider or log in to the UHC member portal to learn more.

For 2026, verification of a qualifying condition will be required to spend your monthly OTC credit on healthy food and utilities. But, there’s good news. We've already verified a qualifying condition for 95% of our eligible members. This verification process is exclusive to UnitedHealthcare. Verified status does not transfer to other Medicare Advantage brands.

 

Important Dual Special Needs plan changes explained

2026 D-SNP benefit changes: What you should know

Video transcript

Hello! If you rely on a Medicare Advantage plan for non-medical benefits like credits for healthy food or utilities, there is an important industry change that you should know about.

 

Starting in 2026, the Centers for Medicare and Medicaid Services (CMS) will end the Value-Based Insurance Design program, or VBID for short. VBID helped Medicare Advantage plans, including Dual Special Needs plans, or D-SNP, provide extra benefits like lower prescription drug costs or credits to help pay for food and utilities, rides and housing. 

 

With the government ending this program, some of these non-medical benefits may be going away or offered in a different way in 2026. 

Lower prescription drug costs

Credits to help pay for food

Credits to help pay for utilities
 

For example, many programs to support Medicare Advantage members will continue. However, to keep or receive some of these benefits, your Medicare plan may need to verify with your provider that you have chronic high blood pressure, diabetes, cardiovascular disease or another qualifying condition. 

 

Plans may be impacted differently, so keep an eye on your mailbox and inbox for more information from your insurer beginning with the Annual Notice of Changes document, or ANOC, in September. 

 

Big changes can raise big questions—but you don’t have to navigate them alone. UnitedHealthcare is here to help you understand your coverage now and no matter what comes next. 

 

For the latest information about this change and other Medicare industry news, visit uhc.com/medicare.


 

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A nationwide policy change may affect benefits in 2026
 

  • The Centers for Medicare & Medicaid Services has ended the VBID program, which allowed Dual Special Needs plans to offer $0 copays on all covered Part D prescriptions and provide additional benefits like credits to help pay for food and utilities, rides and housing.
  • The Extra Help program will help keep prescription costs lower and some additional savings may be available through other programs, depending on your plan.
  • For additional benefits like a credit for healthy food and home utilities, you will need to verify a qualifying chronic condition such as chronic high blood pressure, diabetes or cardiovascular disease. Before the Annual Enrollment Period (October 15 to December 7), watch for an Annual Notice of Change (ANOC) from your insurer. This notice will include information about benefits that are affected.
  • Before you enroll, we recommend reviewing your plan’s benefits to ensure they meet your health and financial needs. If you need to make a change, you can contact your insurer or speak with a local agent to learn about plans and coverage.


*Plans may not be available in all areas/markets.

Monthly Special Enrollment Period (SEP)
 

If you're eligible for Medicare and have full Medicaid benefits, there is now a monthly Special Enrollment Period.

Special Enrollment Period limited to integrated plans
 

During this new Special Enrollment Period, you may enroll in select D-SNPs from the same insurer who manages your Medicaid coverage.

2025 enrollment changes explained

Video transcript

If you are enrolled in or considering a Dual Special Needs plan, you should know about some changes to the enrollment period starting in 2025. These changes for Medicare can affect your coverage decisions. UnitedHealthcare is here to help.
 

Medicare is phasing in several changes to encourage more coordination between Medicare and Medicaid benefits. Here’s what’s changing.
 

In 2025, there’s a new Special Enrollment Period. Instead of the existing quarterly Special Enrollment Period for people who have Medicare and Medicaid, there will be a new monthly Special Enrollment Period. This is only for people with full Medicaid benefits who are enrolling in a Dual Special Needs plan that would allow them to receive Medicare and Medicaid benefits from the same company.
 

People with Medicare and Medicaid can still enroll in a Dual Special Needs plan when they first become eligible during the Annual Enrollment Period or during the Medicare Advantage Open Enrollment Period. Only certain Dual Special Needs plans can be selected during the new monthly Special Enrollment Period. However, people who qualify for any Medicare benefits, including Dual Special Needs plan coverage, can still renew or change their plans during the Annual Enrollment Period.
 

You deserve to feel confident in your Medicare plan choices. Count on UnitedHealthcare and our more than 45 years of experience. To help navigate these changes and support you in finding the right plan that fits your needs.



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Here's what you need to know:

 

Monthly chance to switch between integrated D-SNPs for dual eligibles
 

  • If you’re eligible for Medicare and have full Medicaid benefits, there is a new monthly SEP instead of the quarterly ones you may be used to.
  • Integrated care SEPs allow enrollment in select D-SNPs and Medicaid plans under one insurer.
  • Beside this new monthly enrollment period, all dual-eligible beneficiaries can still enroll during the Annual Enrollment Period (AEP) or a Medicare Special Enrollment Period with a qualifying life event. There may be other opportunities to enroll as well.


*Plans may not be available in all areas/markets.

New enrollment rules will make Medicare and Medicaid work better together
 

  • Starting in 2025, if you are eligible for Medicare and have full Medicaid benefits, there is a new monthly SEP that may help combine your Medicare and Medicaid coverage with one insurer.
  • During this monthly SEP, you may sign up for a D-SNP from the same insurer that manages your Medicaid coverage.
  • Qualified plan options for this enrollment period depend on where you live and which insurer you use.
  • This Special Enrollment Period does not apply if you have partial Medicaid benefits or just Extra Help, also known as Low-Income Subsidy (LIS).


*Plans may not be available in all areas/markets.

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    Additional resources and materials


    Explore articles for more in-depth information related to Dual Special Needs plans.
    From choosing your plan to using your plan, we're committed to helping you every step of the way. 

    2026 OTC, healthy food and utility benefit changes
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