CNC · 10-Q · 2026Q1 · Full report

Dual‑eligible D‑SNP integration

CENTENE CORP · 2026-04-28 · Importance 59 · Surprise 60

CMS finalized rules in its calendar year 2025 Medicare and Part D policy requiring dually enrolled Medicare and Medicaid beneficiaries to receive integrated care through the Medicaid company's Medicare Advantage Dual Eligible Special Needs Plans (D‑SNPs) beginning in 2030, with certain restrictions beginning in 2027. The D‑SNP integration requirement is intended to enhance coordination of care and Centene expects this to be a long‑term growth opportunity given its overlapping Medicaid and Medicare Advantage footprints. Centene has taken enterprise‑level focus on the D‑SNP opportunity and is positioning its subsidiaries (citing new FIDE SNP and HIDE SNP contracts in Illinois, Ohio and Michigan) to capture expected benefits from integrated dual‑eligible models.

Key facts

• CMS calendar year 2025 Medicare and Part D rule requires dually enrolled beneficiaries to receive integrated care through Medicaid company's Medicare Advantage D-SNPs beginning in 2030 with certain restrictions beginning in 2027.
• The company operated MMPs through December 31, 2025; in 2026 these members are included in Medicare due to CMS transition to D-SNP integration.
• Membership definitions note: Medicare March 31, 2026 includes Medicare Advantage, Medicare Supplement, and Applicable Integrated Plans (AIPs) as a result of CMS transition to D-SNP integration in 2026.

Impact estimates