How a D-SNP works
Medicare.gov describes special needs plans as Medicare Advantage plans that limit membership to people with specific needs. A D-SNP serves people with both Medicare and Medicaid. Every SNP includes Part D drug coverage. The plan pays first for Medicare-covered care, and SoonerCare pays after it.
Medicare Advantage plans may offer extra benefits Original Medicare doesn't cover, such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.
What's different in Oklahoma
- A contract with OHCA. Under 42 CFR 422.107, every D-SNP must have a contract with the state Medicaid agency, in Oklahoma the Oklahoma Health Care Authority. The contract covers which dual-eligible groups can enroll, how the plan coordinates SoonerCare benefits and the cost-sharing protections it gives.
- SoonerCare stays with OHCA. OHCA's rule OAC 317:55-3-1 excludes dual-eligible and Medicare Savings Program members from SoonerSelect managed care, so your SoonerCare benefits are not run by a SoonerSelect plan.
- Statewide availability. In CMS's 2027 Landscape file, all 77 counties have at least one D-SNP. In seven western counties (Beaver, Cimarron, Ellis, Harmon, Harper, Roger Mills and Texas), special needs plans are the only Medicare Advantage plans for 2027. See plans ending in 2027.
How to choose a D-SNP
- Confirm your SoonerCare level. Check your OKDHS approval notice: full SoonerCare, QMB Plus, SLMB or QI-1.
- Check your doctors and drugs. Ask whether your doctors, hospital and pharmacy are in the plan's network, and look up your drugs on the plan's formulary.
- Compare plans in your county. You can see plans for your ZIP code, or request a call from a licensed insurance agent to compare D-SNPs from the companies they work with.
- Enroll in an allowed period. Use Open Enrollment or a special enrollment period you qualify for.
Related questions
Can I have SoonerCare and Medicare Advantage?
Your plan options as a dual-eligible member.
Can I have SoonerCare and Medicare?
Who pays first and what SoonerCare adds.
D-SNPs in Oklahoma
The full guide, with the SoonerCare and Medicare guide.
Sources
- Medicare.gov — Special Needs Plans (SNP)
- 42 CFR 422.107 — Requirements for dual eligible special needs plans
- OHCA — OAC 317:55-3-1, SoonerSelect excluded populations
- OHCA — OAC 317:30-3-25, Crossovers (deductibles, coinsurance, and copays)
- Medicare.gov — Special Enrollment Periods
- CMS — CY2027 Medicare Advantage and Part D Landscape file (November 2026)
More questions in this guide
- Can I have SoonerCare and Medicare at the same time?
- Can I have SoonerCare and a Medicare Advantage plan?
- Does Medicare or SoonerCare pay for a nursing home in Oklahoma?
- Does SoonerCare pay my Medicare premiums?
- What is the ADvantage waiver in Oklahoma?
Part of the guide: SoonerCare and Medicare: a guide for Oklahoma dual eligibles · All questions
Frequently asked questions
Who can join a D-SNP in Oklahoma?
You need Medicare Part A and Part B, SoonerCare or a Medicare Savings Program, and to live in the plan's service area. Federal rules (42 CFR 422.107) require each D-SNP's contract with OHCA to state which groups of dual-eligible members it can enroll, so not every D-SNP accepts every level of SoonerCare.
Do I lose SoonerCare if I join a D-SNP?
No. You keep SoonerCare. OHCA's crossover rule says SoonerCare pays Medicare deductibles, coinsurance and copays under Part C (Medicare Advantage) as well as Parts A and B.
When can I join or leave a D-SNP?
During Open Enrollment, October 15 to December 7, 2026, for coverage starting January 1, 2027. Medicare.gov also says people with Medicaid or Extra Help can change drug coverage once a month, and people with full Medicaid can join an integrated D-SNP once a month if one is offered where they live.
How many D-SNPs are there in Oklahoma?
CMS's 2027 Landscape file lists 27 special needs plans of all types in Oklahoma, including D-SNPs, and every county has at least one D-SNP. The number varies by county, so check by ZIP code.
Medicare in your Oklahoma county
Plans, local agents and help, county by county: Oklahoma · Tulsa · Cleveland · Canadian · Comanche · Rogers · Wagoner · Payne · Pottawatomie · Creek · Muskogee · Garfield · Grady · Washington · Logan · Bryan · Le Flore · Carter · Cherokee · McClain · All 77 counties →
