A D-SNP, or Dual Eligible Special Needs Plan, is a Medicare Advantage plan for people with both Medicare and TennCare. Starting January 1, 2027, Tennessee requires people with full benefits who want a D-SNP to get their Medicare and TennCare Medicaid from the same health plan. If your D-SNP and your TennCare plan are with different companies, you need to match them or you may be disenrolled from the D-SNP. Here is what is changing, who qualifies and how to make the switch.
What is a D-SNP in Tennessee?
TennCare describes a D-SNP as a Medicare Advantage plan designed for people who have both Medicare and Medicaid. Everyone who qualifies has Medicare Part A, Part B or both, and either full or partial Medicaid. TennCare's D-SNP page explains that Tennessee offers Fully Integrated Dual Eligible Special Needs Plans, or FIDE SNPs, for people who qualify for both programs and are under a single health plan.
A D-SNP covers your Medicare hospital, medical and drug benefits in one plan, and it must include Part D drug coverage. People with TennCare usually also get Extra Help, which keeps drug copays low. Partial duals, people who don't have full Medicaid but get state help paying Medicare premiums or cost sharing, can also be eligible for certain D-SNPs. Many plans add extra benefits, such as dental, vision or allowances for healthy food, which TennCare's own member stories mention. Those benefits vary by plan, so check the details.
What changes on January 1, 2027?
TennCare says that by January 2027, full benefit dual eligible individuals who want to be in a D-SNP must get Medicaid and Medicare benefits from the same health plan. If your Medicare D-SNP and your TennCare Medicaid plan don't match, beginning January 1, 2027, they must be with the same company.
TennCare lists two ways to avoid being disenrolled from your D-SNP:
- Change your Medicare D-SNP to match your TennCare Medicaid plan.
- Change your TennCare Medicaid plan to match your Medicare D-SNP.
Which way makes sense depends on your doctors, your prescriptions and any CHOICES or home care services you receive. Before you change either plan, check that the doctors and services you rely on are covered by the plan you're moving to.
What is the difference between a FIDE SNP and a coordination-only D-SNP?
| Feature | FIDE SNP (fully integrated) | Coordination-Only D-SNP |
|---|---|---|
| Medicare and Medicaid | Both managed by one health plan | Medicare through the D-SNP; Medicaid through a TennCare health plan |
| Member experience | One care coordinator, one ID card, one handbook, one provider directory, combined notices, one appeals process | Separate cards and processes for each program |
| Who can enroll | Full benefit dual eligibles enrolled in the same company's TennCare plan | Limited to Qualified Medicare Beneficiaries and certain waiver members |
TennCare encourages people to enroll in their TennCare health plan's D-SNP to simplify coordination of both programs through one plan. Its D-SNP brochure lists the single care coordinator, single card and unified appeals as the main benefits.
Who qualifies for a D-SNP in Tennessee?
According to TennCare, you qualify if you:
- Have Medicare Part A and Part B, or receive help from a qualifying Medicare Savings Program.
- Receive TennCare Medicaid.
- Live in Tennessee.
TennCare publishes a D-SNP comparison chart with each plan's profile and contact information. Our page on having Medicare and TennCare at the same time explains the Medicaid categories, and our page on help paying for Medicare in Tennessee covers Medicare Savings Programs.
When can I switch to match my plans?
TennCare points to a Special Enrollment Period for people eligible for both Medicare and Medicaid. It gives them a chance every month to move into a fully integrated D-SNP, which lets you match your D-SNP to your TennCare plan. Medicare's Special Enrollment Period rules say changes made this way take effect the first day of the next month. You don't have to wait for Open Enrollment, but acting early avoids any disruption on January 1, 2027.
What should I do before January 1, 2027?
If you or a parent has both Medicare and TennCare, use this checklist now:
- Find the name of the company on your Medicare D-SNP card and on your TennCare health plan card.
- If they are the same company, you are already matched. Confirm with the plan that you are in its fully integrated D-SNP.
- If they are different, list your doctors, hospitals, prescriptions and any CHOICES or home care services.
- Check each item against both companies' networks and drug lists to see which match keeps the most of your care in place.
- Make the change to your D-SNP or to your TennCare plan, and write down the confirmation and the start date.
- Watch your mail for new ID cards and a new handbook, and carry the new card to your next appointment.
If a letter from TennCare or your plan arrives about this change, don't set it aside. It usually includes a deadline and the options available to you.
How do D-SNPs work with TennCare CHOICES?
CHOICES is TennCare's program for long-term services and supports, including nursing facility care and certain home and community-based services for older adults and adults with physical disabilities. In a FIDE SNP, the same health plan coordinates your Medicare benefits, such as home health visits or durable medical equipment, with your CHOICES services. TennCare's examples include members who stay safely at home with in-home support from CHOICES and skilled nursing visits through Medicare, coordinated by one care team. If a parent receives CHOICES services, protecting that coordination should drive the decision about which company to match.
How The Jordan Insurance Agency can help
The January 1, 2027 matching rule means many Tennessee families need to act now. From our Nashville office, we'll check which company manages your TennCare plan and your D-SNP, confirm your doctors and prescriptions on each side, and help you choose the match that disrupts your care the least. If you're helping a parent in the Nashville, Franklin or Murfreesboro area, we'll walk through it with both of you. Schedule Your Consultation to review your options.
Reviewed by Billy Jordan Jr., licensed insurance agent · Licensing & Credentials · Last reviewed November 12, 2026 · Sources are linked in the answer above.
Licensing: Billy Jordan Jr. is licensed in 23 states, including North Carolina, South Carolina and Tennessee. See Licensing & Credentials.
Office: Tennessee clients are served by the Nashville office, 159 4th Ave N, Suite 100, Nashville, TN 37219, (615) 558-6082.
Medicare disclaimer: We do not offer every plan available in your area. Currently we represent 7 organizations which offer 65 products in your area (Tennessee). Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Read the full Medicare disclaimer.
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