If you have both Medicare and Medicaid, you may qualify for a Special Enrollment Period (SEP) that allows you to join or switch plans outside of the usual Medicare enrollment windows. One important SEP is the Integrated SEP, which applies in states that offer fully or highly integrated Medicare-Medicaid plans.
If you have both Medicare and Medicaid, you may be able to change your Medicare Advantage plan outside of the usual enrollment periods. One way to do that is through the Integrated Special Enrollment Period (SEP).
This guide explains:
- What the Integrated SEP is
- The difference between FIDE SNPs and HIDE SNPs
- What Medicaid levels qualify
- Which states offer integrated options
- Additional state requirements like CHOICES in Tennessee
What Is the Integrated SEP?
The Integrated SEP is a special enrollment period that lets people with full Medicaid and Medicare enroll into a FIDE SNP or HIDE SNP in states where these plans are offered. You can use this SEP once per quarter during the first three quarters of the year (January–September).
This SEP is only available if:
- You have full Medicaid
- You live in a state that offers integrated dual eligible plans
- You’re enrolling into a plan approved by your state Medicaid program
What Is a FIDE SNP?
A FIDE SNP (Fully Integrated Dual Eligible Special Needs Plan) is a Medicare Advantage plan that manages:
- Medicare Part A and Part B
- Part D drug coverage
- Medicaid services like dental, vision, and long-term care
FIDE SNPs offer complete integration of Medicare and Medicaid benefits. You get one plan, one insurance card, and one care team. These plans often work hand-in-hand with your state Medicaid agency.
Important: Some FIDE SNPs require that you be enrolled in specific state programs, like CHOICES in Tennessee.
What Is a HIDE SNP?
A HIDE SNP (Highly Integrated Dual Eligible Special Needs Plan) also serves people with full Medicaid and Medicare. Like FIDE SNPs, it may offer extra benefits and coordinate care.
The difference is that HIDE SNPs are only partially integrated:
- They cover Medicare services and some Medicaid benefits
- They do not manage all Medicaid services
- You typically don’t have to be enrolled in a specific state waiver or long-term care program
You may qualify for the Integrated SEP when enrolling into a HIDE SNP, depending on your Medicaid status and state.
Medicaid Levels That May Qualify
To use the Integrated SEP, you usually need full Medicaid. This includes:
- FBDE (Full Benefit Dual Eligible)
- QMB+ (Qualified Medicare Beneficiary + full Medicaid)
- SLMB+ (Specified Low-Income Medicare Beneficiary + full Medicaid)
- Institutional Medicaid or those receiving long-term care through a state waiver
People who are QMB-only or SLMB-only do not qualify for FIDE or HIDE SNPs and cannot use the Integrated SEP.
States That Offer FIDE or HIDE SNPs
As of 2025, the following states support integrated dual eligible plans that allow for the Integrated SEP. Plan availability depends on your Medicaid status and the county you live in.
| State | Integrated Program Name | FIDE/HIDE | Medicaid Requirement |
|---|---|---|---|
| Tennessee | CHOICES | FIDE | Must be enrolled in CHOICES 1, 2, or 3 |
| New York | Medicaid Advantage Plus (MAP) / MLTC | FIDE / HIDE | Must be in MLTC or MAP program |
| Minnesota | MSHO | FIDE | Must qualify for MSHO |
| Massachusetts | One Care | FIDE | Must be ages 21–64 and on MassHealth Standard |
| California | Medi-Cal Managed Care / MMP | HIDE / FIDE | Must be enrolled in Medi-Cal managed care |
| Illinois | MMAI | FIDE | Dual eligible + in Medicaid Managed Care |
| Ohio | MyCare Ohio | FIDE | Dual eligible + in MyCare Medicaid plan |
| Texas | STAR+PLUS | HIDE / FIDE | Must be in STAR+PLUS Medicaid |
| Michigan | MI Health Link | FIDE | Full Medicaid and Medicare eligibility |
| South Carolina | Healthy Connections Prime | FIDE | Full dual + enrolled in Prime |
| Rhode Island | Rhody Health Options | FIDE | Full dual + LTSS eligibility |
Note: Some states offer both HIDE and FIDE SNPs. Eligibility depends on state Medicaid programs and plan contracts.
Tennessee Example: CHOICES 1, 2, and 3
In Tennessee, you must be enrolled in the CHOICES Medicaid program to qualify for a FIDE SNP and use the Integrated SEP. The CHOICES groups are:
- CHOICES 1 – People who live in a nursing home
- CHOICES 2 – People who qualify for nursing home care but get services at home
- CHOICES 3 – People at risk of needing a nursing home in the future
Only certain plans like BlueCare Plus and Wellpoint FIDE SNPs are available to CHOICES enrollees.
What If You’re Not in an Integrated State?
If your state does not offer FIDE or HIDE SNPs, or you don’t meet the Medicaid requirements, you may still qualify for other SEPs, such as:
- Dual SEP – Available once per quarter for full-duals
- LIS SEP – If you receive Extra Help
- Disaster SEP – In case of a FEMA-declared emergency
- Medicaid Change SEP – If your Medicaid level changes
Talk to a licensed agent to find the best available option for your situation.
Final Thoughts
FIDE and HIDE SNPs offer an easier way to get care by combining your Medicare and Medicaid benefits into one plan. The Integrated SEP is designed to make enrollment into these plans smoother for people who qualify — but it’s only available in certain states and only under certain conditions.
If you’re not sure whether you qualify, or if you want help reviewing your options, Liberty Senior Benefits is here to help. We’ve worked with over 30,000 seniors to navigate Medicare and Medicaid rules — and our guidance is always free.
Appointments are available by phone, video, or in person.