Aligning Enrollment

States using Dual Eligible Special Needs Plans (D-SNPs) as a platform for Medicare-Medicaid integration often try to promote aligned enrollment (i.e., enrollment of dually eligible individuals into a D-SNP and an affiliated Medicaid managed care plan offered by the same parent company in the same geographic area) to advance their integration efforts.

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• Selectively Contracting with D-SNPs to Promote Alignment With Medicaid Managed Care Plans

  This webinar explains the potential benefits for states of selectively contracting with D-SNPs, key building blocks for selective contracting, considerations for states when deciding to selectively contract with D-SNPs, and steps that states can take when implementing selective contracting. (ICRC, February 2023)

• Tips to Improve Medicare-Medicaid Integration Using D-SNPs: Promoting Aligned Enrollment

  This tip sheet outlines tips for promoting aligned enrollment (i.e., enrollment of dually eligible beneficiaries in D-SNPs and Medicaid managed care plans offered by the same parent company in the same geographic area (aligned plans) as an integration tool. (ICRC, April 2018)

• Resources on exclusively aligned enrollment

  ICRC has published several resources on exclusively aligned enrollment, which occurs when a state limits D-SNP enrollment to full-benefit dually eligible individuals who receive their Medicaid benefits from the D-SNP or an affiliated Medicaid managed care plan offered by the same parent organization as the D-SNP. These resources explain how exclusively aligned enrollment promotes integration of Medicare and Medicaid benefits for D-SNP enrollees, as well as key considerations and decisions for states interested in requiring exclusively aligned enrollment.

• Using Default Enrollment to Align Coverage for Dually Eligible Medicare-Medicaid Beneficiaries

  This fact sheet summarizes default enrollment requirements and state roles in the default enrollment approval and implementation process. (ICRC, May 2025)

• Aligning Coverage for Dually Eligible Beneficiaries Using Default and Passive Enrollment

  This webinar provides a history of default enrollment and its requirements as well states’ roles in this process, including the need to identify beneficiaries newly eligible for Medicare. (ICRC, July 2018)