Who is actually in a Special Needs Plan, and where is the room left?
8,437,333 people are enrolled in a Special Needs Plan — 6,500,322 in a D-SNP, 1,806,608 in a C-SNP and 130,403 in an I-SNP. The national D-SNP capture proxy is 51.8% — August 2026 D-SNP enrollment over the April 2026 dual population, two different CMS products, so it sizes a market rather than measuring an enrollment rate. The state spread is what matters: Louisiana reads 73.3% and Oregon 18.7% on the same proxy.
Build a D-SNP marketing strategy. The D-SNP marketing view takes this same SNP file and adds the proxy uncaptured dual opportunity, carrier concentration and market archetypes for campaign planning.
D-SNP
C-SNP
I-SNP
Fully integrated (FIDE)
All three are Medicare Advantage plans restricted to a specific population, which lets them tailor benefits and networks in ways an open plan cannot.
D-SNP serves dual eligibles — people on both Medicare and Medicaid. It is by far the largest of the three at 77% of all SNP enrollment, and it carries the large majority of SNP enrollment in this file Derived interpretation.
C-SNP serves people with a qualifying chronic condition. In practice it is dominated by one bundle. Data fact Cardiovascular disorders, chronic heart failure and diabetes are the most frequently listed qualifying conditions in the plan rows of this file; the counts are in the condition table below.
I-SNP serves people who are institutionalized or need an equivalent level of care at home. It is tiny by comparison — under 1.5% of SNP enrollment — but operationally the most intensive.
How integrated are the D-SNPs?
Integration status determines how far a D-SNP actually coordinates Medicare and Medicaid, and it is the axis CMS keeps tightening. Coordination-only plans do the least; fully integrated plans carry both benefits under one roof.
Contract counts by integration status are not additive. A contract can contain plan benefit packages with more than one integration status, so CO + HIDE + FIDE contract counts sum to more than the distinct D-SNP contract total. Plan counts and enrollment are additive; contract counts are not, and are never summed into a national contract total on this site.
One row explains the plan-count difference. One D-SNP plan in the August 2026 file carries no integration status, so the integration rows sum to 1,082 plans while the plan-level rows count 1,083. The integration sum equals the CMS published D-SNP plan total exactly; the extra row is the site counting a plan CMS leaves out of the integration breakdown.
| Integration status | Enrollment | Share of D-SNP | Contracts | Plans |
|---|---|---|---|---|
| CO | 3,395,520 | 52.2% | 232 | 667 |
| HIDE | 2,316,408 | 35.6% | 132 | 314 |
| FIDE | 788,394 | 12.1% | 72 | 101 |
FIDE = fully integrated dual eligible. HIDE = highly integrated dual eligible. CO = coordination-only. Definitions and the applicable-integrated-plan flag come straight from the CMS report.
SNP enrollment across the states
D-SNP capture proxy · Aug 2026 SNP enrollment / Apr 2026 dual population: how much of the dual population is in a D-SNP?
Derived interpretation This is a market-sizing indicator, not an exact enrollment rate. It divides D-SNP enrollment in the state (August 2026 SNP Comprehensive Report) by the dual-eligible population in that state (April 2026 Medicare Monthly Enrollment). The two inputs are different vintages and different CMS products, so the ratio is a cross-vintage proxy: it cannot prove that a given beneficiary is or is not enrolled in a D-SNP, and D-SNP eligibility rules vary by state and by plan. A low rate with a large dual base is unclaimed ground; a high rate means the fight is over switching, not acquisition.
| State | D-SNP | C-SNP | I-SNP | Dual eligibles | Capture proxy Aug 2026 D-SNP enrollment / Apr 2026 dual population |
Contracts |
|---|---|---|---|---|---|---|
| New York | 762,250 | 23,041 | 13,588 | 1,180,562 | 64.6% | 28 |
| Florida | 682,787 | 329,759 | 7,739 | 928,134 | 73.6% | 31 |
| California | 515,735 | 208,256 | 4,955 | 1,797,355 | 28.7% | 40 |
| Texas | 426,414 | 220,703 | 8,621 | 683,674 | 62.4% | 35 |
| Puerto Rico | 308,050 | 25,231 | 0 | 5,415 | — | 4 |
| Pennsylvania | 258,914 | 25,765 | 2,235 | 475,344 | 54.5% | 20 |
| Ohio | 258,463 | 28,496 | 8,762 | 402,562 | 64.2% | 19 |
| Georgia | 252,926 | 77,475 | 5,363 | 380,910 | 66.4% | 20 |
| North Carolina | 234,278 | 59,470 | 4,540 | 359,194 | 65.2% | 20 |
| Louisiana | 164,070 | 36,267 | 1,799 | 223,850 | 73.3% | 14 |
| Michigan | 163,916 | 29,107 | 2,870 | 338,248 | 48.5% | 22 |
| Alabama | 149,304 | 34,537 | 2,521 | 225,453 | 66.2% | 12 |
| Washington | 140,385 | 9,599 | 4,069 | 237,938 | 59.0% | 13 |
| Indiana | 136,142 | 19,397 | 6,056 | 222,265 | 61.3% | 12 |
| Tennessee | 133,940 | 10,974 | 715 | 236,173 | 56.7% | 12 |
| Arizona | 128,235 | 47,923 | 2,304 | 251,428 | 51.0% | 21 |
| Virginia | 118,332 | 27,771 | 424 | 204,237 | 57.9% | 15 |
| Massachusetts | 117,816 | 2,565 | 0 | 374,447 | 31.5% | 12 |
| Connecticut | 113,059 | 69 | 0 | 208,491 | 54.2% | 8 |
| Missouri | 107,895 | 35,739 | 3,285 | 189,954 | 56.8% | 17 |
| Mississippi | 105,870 | 29,778 | 738 | 163,247 | 64.9% | 15 |
| South Carolina | 105,859 | 82,009 | 1,421 | 174,819 | 60.6% | 11 |
| Kentucky | 103,844 | 12,037 | 1,325 | 179,170 | 58.0% | 15 |
| New Jersey | 99,474 | 2,445 | 1,107 | 231,704 | 42.9% | 7 |
| Wisconsin | 97,607 | 15,320 | 2,562 | 179,860 | 54.3% | 13 |
| Illinois | 84,949 | 85,389 | 2,946 | 394,426 | 21.5% | 17 |
| Arkansas | 80,541 | 45,690 | 2,701 | 132,305 | 60.9% | 13 |
| Colorado | 66,897 | 13,622 | 2,038 | 127,738 | 52.4% | 17 |
| Oklahoma | 62,991 | 31,956 | 696 | 119,016 | 52.9% | 14 |
| Maine | 51,302 | 1,096 | 0 | 105,625 | 48.6% | 8 |
| New Mexico | 44,400 | 11,224 | 0 | 45,780 | 97.0% | 11 |
| Iowa | 42,045 | 25 | 1,525 | 86,142 | 48.8% | 8 |
| Maryland | 40,976 | 1,157 | 516 | 155,956 | 26.3% | 9 |
| West Virginia | 39,813 | 0 | 1,648 | 83,399 | 47.7% | 7 |
| Minnesota | 38,879 | 5,942 | 0 | 138,638 | 28.0% | 10 |
| Nevada | 32,816 | 23,274 | 544 | 85,432 | 38.4% | 16 |
| Hawaii | 32,456 | 280 | 0 | 48,187 | 67.4% | 6 |
| Oregon | 31,708 | 23,467 | 2,177 | 169,911 | 18.7% | 14 |
| Rhode Island | 30,493 | 6,969 | 1,381 | 45,058 | 67.7% | 8 |
| Kansas | 24,410 | 8,660 | 883 | 69,234 | 35.3% | 10 |
| Nebraska | 23,789 | 275 | 649 | 43,874 | 54.2% | 10 |
| Idaho | 22,055 | 8,860 | 280 | 52,761 | 41.8% | 6 |
| Utah | 21,748 | 17,241 | 182 | 34,889 | 62.3% | 11 |
| District of Columbia | 16,990 | 0 | 0 | 34,310 | 49.5% | 2 |
| Delaware | 8,481 | 6,800 | 0 | 32,967 | 25.7% | 7 |
| Montana | 5,848 | 0 | 0 | 24,500 | 23.9% | 3 |
| South Dakota | 4,833 | 0 | 0 | 20,374 | 23.7% | 2 |
| North Dakota | 2,235 | 0 | 332 | 14,917 | 15.0% | 3 |
| Wyoming | 1,332 | 0 | 0 | 12,042 | 11.1% | 1 |
| New Hampshire | 0 | 1,690 | 0 | 30,707 | 0.0% | 1 |
The capture proxy is not shown for Puerto Rico: Medicaid there operates under a block grant and the dual-eligible flag in the Medicare file does not describe the same population, which would put the ratio far above 100%.
Every SNP plan in the country
| Plan | Contract | Type | Integration | States | Enrollment |
|---|---|---|---|---|---|
| The plan explorer needs JavaScript. The complete plan list is available as CSV. | |||||
Who owns the SNP book?
| Parent brand (inferred) | SNP enrollment | Share | Contracts |
|---|---|---|---|
| UnitedHealth Group | 3,015,652 | 35.7% | 47 |
| Other / independent | 2,335,438 | 27.7% | 238 |
| Humana | 983,270 | 11.7% | 18 |
| CVS Health / Aetna | 832,639 | 9.9% | 33 |
| Elevance Health | 376,797 | 4.5% | 15 |
| Centene | 219,621 | 2.6% | 33 |
| Kaiser Permanente | 155,047 | 1.8% | 5 |
| Devoted Health | 147,787 | 1.8% | 31 |
| Molina Healthcare | 140,159 | 1.7% | 17 |
| SCAN | 89,897 | 1.1% | 6 |
| Alignment Healthcare | 84,187 | 1.0% | 5 |
| Blue Cross Blue Shield (other) | 52,121 | 0.6% | 6 |
| Highmark | 4,718 | 0.1% | 2 |
CMS publishes the legal contracting entity, not the parent brand — “Care Improvement Plus South Central Insurance Co.” and “Sierra Health and Life” are both UnitedHealth. The grouping above is inferred by keyword from the contract name and is offered as orientation, not as a filing-grade ownership map. Anything the keyword list does not recognize stays in Other / independent rather than being guessed at. The per-contract figures in the plan table above are exact.
What conditions do C-SNPs actually cover?
| Qualifying condition group | Enrollment | Share of C-SNP |
|---|---|---|
| Cardio DIS CHF and Diabetes | 1,668,780 | 92.4% |
| Cardio Disorders Diabetes | 60,149 | 3.3% |
| Chronic Lung Failure | 41,793 | 2.3% |
| Cardiovascular Disorders,Chronic Heart Failure,Diabetes Mellitus | 17,226 | 1.0% |
| Chronic kidney disease | 11,286 | 0.6% |
| Chronic Mental Health | 2,012 | 0.1% |
| Chronic Heart Failure | 1,495 | 0.1% |
| Chronic Mental Health,Substance use disorders and Chronic Mental Health Disorders | 1,380 | 0.1% |
| Dementia | 1,130 | 0.1% |
| CKD and Post Renal Organ Transplantation | 667 | 0.0% |
| HIV Aids | 606 | 0.0% |
| Overweight obesity and metabolic syndrome | 53 | 0.0% |
The addressable population, county by county
SNP enrollment is published at plan level, so the finest geography CMS gives is the state. The dual-eligible population, though, is available per county — which is how you size a service area below the state line. That layer is on the county explorer, and the full county file is available as CSV: 3,199 counties, 12.0M duals, April 2026.
Where this comes from
SNP enrollment: CMS
Special Needs Plan Comprehensive Report, August 2026, plan-level tab
(SNP_REPORT_PART_17), 1,803 plan records totalling 8,437,333 enrollees. National
totals by type and by integration status are taken directly from the report's own summary tabs
rather than re-derived, so they tie to CMS exactly.
Dual-eligible population: CMS Medicare Monthly Enrollment, April 2026, county geography. The capture proxy therefore compares an August enrollment figure to an April population figure — the two are four months apart. April is the most recent month CMS has published for the monthly enrollment file, so the offset is a limit of the source rather than a choice.
Two CMS suppression rules shape the tables. Individual plans with fewer than 11 enrollees are not named: the report rolls them into three Under-11 aggregate rows (99 enrollees in total — 35 D-SNP, 31 C-SNP, 33 I-SNP), and a further 68 named plan rows carry a suppressed enrollment shown here as zero. Both are counted in the national totals but carry no state, so they sit outside the state table. Separately, 44 plans operate across more than one state (146,934 enrollees, 1.7% of the total); their enrollment cannot be split between states, so they are excluded from the state table and the capture proxy rather than arbitrarily assigned. The plan-level rows sum to exactly the CMS published total of 8,437,333.