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Fully-Integrated Special Needs Plans (FIDE SNP)

A FIDE SNP is a type of health planA group of doctors, specialists, clinics, pharmacies, hospitals, and long-term care providers that work together to meet your needs.
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that covers all your MedicareThe federal health program that provides health care benefits for people age 65 years or older, people age 65 years or younger with certain disabilities, and people with certain diseases.
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and Medi-CalCalifornia’s Medicaid program. Medi-Cal offers health coverage for low-income Californians.
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benefitsMedicare and Medi-Cal cover health care benefits, which are medically-necessary services that you get from your health plan and/or individual providers.
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, as well as some extra benefitsHealth care services provided by your health plan or program that have no extra cost to you.
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.

  • You can get extra help so you can live in your home and community, like having shower grab bars and ramps installed.
  • You will have someone, like a nurse or other helper, whose job is to be your main point of contact and help you get all the health care services you want and need.
  • You have one card to carry and one phone number to call to get help with your care.
  • You will have help to find new providersA person or organization that provides health care-related services, like a doctor, hospital, or clinic.
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    if your providers are not in your health plan’sA group of doctors, specialists, clinics, pharmacies, hospitals, and long-term care providers that work together to meet your needs.
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    networkA group of doctors, hospitals, pharmacies, and other health care professionals that work with your health plan to provide all your health care services.
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    .
  • FIDE SNP health plans are for people who have extra needs and need extra help to safely live in their home and community.
  • FIDE SNP health plans are for people age 65 years or older.
My Choices 
Benefits 

Benefits

  • Includes your Medicare AND Medi-Cal benefits – no more being caught in the middle and being confused about how to get the care and services you need.
  • FIDE SNP health plans cover all your existing benefits, like doctors, hospitals, prescription drugs, medical suppliesSupplies that are typically disposable, single use, medically-related, and often ordered or prescribed by a physician.
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    , medical equipmentThis is equipment ordered or prescribed by your doctor to use at home.
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    , and short-term nursing facilityNursing facilities include nursing homes and rehabilitation facilities and provide nursing, rehabilitative, and medical care.
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    services, plus:
    • Extra dental, hearing, and vision coverage.
    • TransportationMedicare covers emergency ambulance services. Medi-Cal provides transportation to non-emergency, medically-necessary services, like doctor visits or to pick up a prescription.
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      help.
    • Mental healthehavioral health services that focus on mental health, for example counseling or medication you would receive to help with feelings of sadness or stress.
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      and substance use supportBehavioral health services that help people who use substances like alcohol or other drugs.
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    • Personal care support servicesServices you receive in a home to help with activities of daily living like getting in and out of bed, bathing, dressing, preparing meals and eating, and more.
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      .
    • Extra help so you can live in your home and community safely, like shower grab bars and ramps.
    • Gym membership.
  • You can get a Care Coordinator. This is someone, like a nurse or other helper, whose job is to be your main point of contact and help you get all the health care services you want and need.
  • You have just one health plan card to carry and one phone number to call about your health care and other services.
  • FIDE SNP health plans provide home-based, medical and personal care support services through home care agencies (instead of through In-Home Supportive Services, IHSSThe IHSS program provides in-home care for people who cannot safely remain in their own homes without assistance.
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    ).
    • You can still go to an adult day centerCenters that provide daytime health care, such as nursing, therapies, social activities, and meals for people who don’t need care 24/7.
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      of your choice.

Considerations

  • FIDE SNP health plans have networks of providers, like doctors, hospitals, clinics, labs, and equipment suppliers. The health plan will ask you to see the providers in their network, because that is how they can help you best.
    • If your doctor or hospital is not already in the health plan’s network, they might have to join the network, or you may have to switch. You may also have to switch where you get your medical supplies and equipment.
    • Your FIDE SNP Care Coordinator can help you find new doctors and service providers that meet all your needs.
  • If you have an IHSS caregiver, you will have to switch to an agency caregiverA person who provides support for someone who has daily living needs, for example an older adult and/or a person living with a disability.
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    for your in-home services.

To qualify for FIDE SNP, you must:

  • Have both Medicare and Medi-Cal.
  • Be age 65 years or older.
  • Live in a ZIP code where a FIDE-SNP is available.
  • Need a high level of care for a disability or chronic condition.
  • Need extra help to live safely in your home and community and not in a nursing facility.

Contact Health Care Options at 1-800-430-4263 (TTY 1-800-430-7077) to learn more and find out if you are eligible.

Success Stories 

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Next Steps 

Ready to take the next step?

Download Helpful Tools

Use these tools to understand your next steps and organize your health information:

Download Next Steps Checklist

Download Health Profile Worksheet

Contact Help Services

Visit our Get Help page for links and phone numbers to people who can help you understand your Medicare and Medi-Cal benefits and assist you in choosing a care option.

Explore More About FIDE SNP

Medicare.gov

CMS Dual Eligible Special Needs Plans

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