Goodsurance
ES

Medicare Advantage

Dual-Eligible Medicare Advantage Plans Must Issue One Integrated ID Card and a Unified Health Assessment Starting in 2027

Beginning January 2027, certain Medicare Advantage plans serving people with both Medicare and Medicaid must replace two separate membership cards with one and combine their Medicare and Medicaid health risk assessments into a single process, under rules CMS finalized in 2025.

By the Goodsurance editorial teamAugust 4, 2026

About 23 percent of Medicare Advantage enrollees are in special needs plans, and the largest segment of that group, dual eligible special needs plans or D-SNPs, serves people who carry both Medicare and Medicaid coverage. For those members, coordinating benefits has often meant managing two separate insurance cards and receiving independent health checkup contacts from their Medicare and Medicaid plans.

That changes beginning January 1, 2027. CMS rules finalized in 2025 require certain D-SNPs affiliated with a Medicaid managed care organization to take two integration steps. First, plans must issue a single member identification card that functions as the membership credential for both the Medicare and Medicaid plans in which an enrollee is enrolled. Second, rather than conducting separate health risk assessments for Medicare and Medicaid, those plans must conduct one integrated assessment satisfying both programs' requirements at once.

Starting in 2027, certain Medicare Advantage plans for dual-eligible members must issue one ID card covering both Medicare and Medicaid, and combine separate health check-ins into one.

CMS framed the requirements as part of a broader effort toward fully integrated care for dual-eligible individuals, a population federal regulators have identified as underserved by fragmented coverage arrangements. D-SNP enrollment has grown sharply in recent years. Enrollment in all special needs plans rose 23 percent between 2025 and 2026, according to KFF, representing more than 85 percent of net new Medicare Advantage enrollment over that period.

For affected members, the practical effect arrives in late 2026 when plans begin distributing 2027 enrollment materials. Members should expect to receive one integrated card rather than two separate ones, and a single outreach contact for the combined health assessment rather than separate calls from their Medicare and Medicaid plans.

In plain words

Some Medicare Advantage plans, called D-SNPs, cover people who have both Medicare and Medicaid. Many of these people carry two different ID cards, one for each program, and get two separate health check-in calls each year. Starting January 2027, certain D-SNPs must give members just one card covering both programs and do one combined health check-in instead of two. This is meant to make the process simpler for people using both Medicare and Medicaid. If you are in a D-SNP, look for new materials in late 2026 explaining these changes.

Understand the basics first

Source: CMS
Read at the source →

More news

Other stories on what is moving in Medicare.

Medicare Advantage

Medicare Advantage Supplemental Benefits Are Hard to Compare During Open Enrollment, Group Finds

Plans often omit key details from shopping tools and use non-standard language, making it difficult for enrollees to find the right match before December 7.

October 30, 2026

Medicare Advantage

Devoted Health Named to Fill Medicare Advantage Gap in Two Rural New Hampshire Counties

Coos and Carroll counties were left without any standard Medicare Advantage plan for 2027 after insurers pulled back. A late CMS approval makes Devoted Health plans available starting November 1, partway through open enrollment.

October 24, 2026

Medicare Advantage

The 2027 Medicare Advantage Reset: Who Ordered It, Who Pays

About 3.16 million people lose their Medicare Advantage plan for 2027, the third straight year the number has grown. Who made the decisions, what they said, and where it hits hardest.

October 19, 2026

Medicare Advantage

GAO Report Flags 23.7 Billion Dollars in Medicare Advantage Improper Payments and Calls for Stronger Fraud Controls

The Government Accountability Office found that Medicare Advantage improper payments hit an estimated 23.7 billion dollars in fiscal year 2025, representing about 6.1 percent of the program's outlays, while CMS has yet to complete a comprehensive fraud risk assessment.

October 18, 2026

Medicare Advantage

KFF: Nearly Three-Quarters of Medicare Advantage Enrollees Have a Condition That Could Block a Medigap Policy

A KFF analysis published the day before open enrollment opens finds that most people in Medicare Advantage plans carry diagnoses that Medigap insurers can use to deny or reprice coverage if those enrollees try to return to Original Medicare.

October 14, 2026

Medicare Advantage

MedPAC Analysis Finds Medicare Advantage Provider Directories May Overstate Physician Network Participation

A new presentation to Congress's Medicare advisory body compared plan directories to actual encounter records and found meaningful gaps, raising concerns just as open enrollment opens October 15.

October 10, 2026