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2027 plans · CMS data

Medicare Special Needs Plans in District of Columbia

Every Special Needs Plan in District of Columbia for 2027, from the CMS plan landscape file. You can join one only if you fit its group: Medicare and Medicaid (D-SNP), a qualifying chronic condition (C-SNP) or nursing-home-level care (I-SNP). Pick your county to see the plans sold there.

3D-SNPs for Medicare and Medicaid
0C-SNPs for chronic conditions
1I-SNPs for institutional care
3rated 4+ stars by CMS

Showing all 4 plans.

D-SNPs: Medicare and Medicaid

Sorted by CMS star rating, then by how closely the plan is integrated with District of Columbia Medicaid, then by worst-case year. If Medicaid or the QMB program pays your Medicare cost sharing, the out-of-pocket maximum matters less than the network and how well the plan works with Medicaid.

#PlanPremium / monthIn-network max out-of-pocketWorst-case yearStars
1 UHC Dual Choice DC-Y2 (PPO D-SNP)UnitedHealthcare · PPO D-SNPHighly integrated (HIDE) · $0 Medicare cost sharingAll 1 counties $0 $9,850 $9,850 4★
2 UHC Dual Choice DC-Q001 (PPO D-SNP)UnitedHealthcare · PPO D-SNPCoordination-only · $0 Medicare cost sharingAll 1 counties $0 $9,850 $9,850 4★
3 UHC Dual Choice DC-YL1 (HMO D-SNP)UnitedHealthcare · HMO D-SNPHighly integrated (HIDE) · $0 Medicare cost sharingAll 1 counties $0 $9,850 $9,850 3★

I-SNPs: institutional care

For people who live, or are expected to live, at least 90 days in a nursing home or similar facility, or who need that level of care at home. Sorted by worst-case year.

#PlanPremium / monthIn-network max out-of-pocketWorst-case yearStars
1 UHC Nursing Home Plan EX-F004 (PPO I-SNP)UnitedHealthcare · PPO I-SNPFacility-basedAll 1 counties $0 $9,850 $9,850 5★

Worst-case year = 12 × monthly plan premium + in-network maximum out-of-pocket, for covered Part A and B services. Many D-SNP members pay $0 in premiums with Extra Help. Star ratings are CMS’s 2027 overall ratings for the contract behind each plan. Plans under CMS sanction aren’t listed. How we sort

Before you enroll: check the plan’s network and drug list in the official Medicare Plan Finder, and ask the plan whether you qualify. Free one-on-one help: your State Health Insurance Assistance Program.

Questions

How many Special Needs Plans are in District of Columbia for 2027?

CMS lists 4: 3 D-SNPs (Medicare and Medicaid), 0 C-SNPs (chronic conditions) and 1 I-SNPs (institutional), from 1 parent company. Not every plan is sold in every county; use the county filter.

Which D-SNPs in District of Columbia are integrated with Medicaid?

2 of the 3 D-SNPs are fully integrated, highly integrated or applicable integrated plans, which cover or coordinate Medicaid benefits more closely. The rest are coordination-only plans. Integrated plans are listed first among plans with the same star rating.

Do Special Needs Plans include drug coverage?

Yes. Every Special Needs Plan must include Part D drug coverage.

Can I stay in a Special Needs Plan if I no longer qualify?

Only while you still meet the plan's rules. If you lose eligibility, you may get a Special Enrollment Period to join another plan.

Sources

  1. CMS, CY 2027 Medicare Advantage and Prescription Drug Plan Landscape (CY2027_Landscape_202609.csv), Special Needs Plan rows — cms.gov; star ratings from the CMS 2027 Star Ratings Data Tables — cms.gov.
  2. Medicare.gov, “Special Needs Plans” — medicare.gov.

Educational information, not a recommendation to join any plan. We are not an insurance agent or broker, and we are not connected with or endorsed by the U.S. government or the federal Medicare program. Plan details can change; confirm with the plan or Medicare.gov. · Advertiser disclosure

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