Miami-Dade County, FL April 10, 2026  ·  Medicare Advantage  ·  D-SNP / Dual-Eligible

Miami-Dade 2027: D-SNP Plans Are Shifting — What the 4.5-Star Aetna Plans Leaving Dual-Eligible Seniors Behind Would Actually Cost You

By Sarah Chen-Watkins, Editor-in-Chief — Washington, D.C.  |  Reported from CMS Medicare Plan Finder data, FRED Medical CPI, and Florida Agency for Health Care Administration records.

What Is Actually Happening in Miami-Dade's D-SNP Market Right Now?

Let me give you the honest version, not the press-release version.

Miami-Dade County has 115 Medicare Advantage plans available for 2026, according to CMS Medicare Plan Finder data. That sounds like abundance. It isn't — not if you're dual-eligible, meaning you receive both Medicare and Medicaid. Because within that 115-plan universe, the plans specifically designed for you — Dual-Eligible Special Needs Plans, or D-SNPs — represent a much narrower slice. And that slice is getting squeezed.

CVS Health Corporation (operating under the Aetna brand) currently offers at least three distinct D-SNP products in Miami-Dade. That's notable because CVS Health announced in early 2025 a sweeping restructuring of its Medicare Advantage business, exiting certain markets and repricing others. The company projected over $3 billion in Medicare losses in 2024 alone. (Nothing says "we're committed to your community" like nine-figure losses followed by strategic market review.)

For dual-eligible Miami-Dade seniors, the question isn't abstract. It's: will my specific plan be here in January 2027?

Which D-SNP Plans Are Currently in Miami-Dade — And Which Should You Watch Closely?

Here is every D-SNP plan in Miami-Dade County for which CMS has published 2026 data, with contract IDs, premiums, and star ratings. This is the landscape that could shrink for 2027.

Source: CMS Medicare Plan Finder, 2026 plan year. medicare.gov/plan-compare

Notice something? Every single D-SNP plan in Miami-Dade County is operated by one carrier: CVS Health Corporation under the Aetna brand. That's not diversification. That's a single point of failure. If Aetna restructures out of this market — even partially — dual-eligible Miami-Dade seniors have zero D-SNP backup from another carrier in the current data.

"One carrier. Three D-SNP plans. 4.5 stars across the board. Miami-Dade's dual-eligible seniors are sitting on a single-vendor dependency that most hospital CFOs would call unacceptably risky."

Why Is CVS Health / Aetna Under Pressure in Florida — And What Does That Mean for Your Plan?

CVS Health reported over $3 billion in Medicare Advantage losses in 2024 and announced in late 2024 that it would be "right-sizing" its MA footprint. The company's CEO was replaced. The stock dropped. The phrase "strategic market review" appeared in earnings calls fourteen times (I counted; occupational hazard).

For Miami-Dade specifically: Florida is one of the highest-cost Medicare Advantage markets in the country. Miami-Dade's senior population skews older, sicker, and more dual-eligible than the national average. That's exactly the demographic profile that has been losing insurers money in recent years.

Medical care services inflation, measured by FRED's CUSR0000SAM2 index, hit 648.884 in February 2026 — a 3.66% increase year-over-year. The broader Medical Care CPI (CPIMEDSL) reached 592.554 in the same period, up 3.22%. When your costs are rising faster than your reimbursements, you exit markets. That's the math driving 2027 exits nationally, and Miami-Dade isn't immune.

What Does a 4.5-Star D-SNP Plan Actually Provide — And Why Losing It Matters More Than the Premium

When people see "$3.90 a month" or "$1.30 a month," they think the stakes are low. They're wrong. The premium is almost irrelevant. What you're actually buying — and potentially losing — is the benefit structure that 4.5-star D-SNP plans carry.

A 4.5-star plan must score well on CMS quality measures including chronic disease management, preventive care access, member complaints, and customer service responsiveness. For dual-eligible seniors — who statistically have more chronic conditions, lower health literacy scores, and higher rates of functional limitations than non-dual Medicare beneficiaries — these quality distinctions aren't bureaucratic noise. They're the difference between a care coordinator who calls you and one who doesn't.

D-SNP plans in Florida are also required to coordinate with Medicaid — meaning your dental, vision, and transportation benefits (often Medicaid-funded) must be integrated with your Medicare coverage. Lose the D-SNP, and that coordination breaks down. You don't just lose a plan. You lose a scaffolding.

How Does Miami-Dade's D-SNP Situation Compare to Broward and Palm Beach Counties?

Context matters here. Our colleagues covering Broward County found 3 carrier exits affecting Broward's Medicare Advantage market. Palm Beach County seniors face their own D-SNP disruptions heading into 2027, as reported in our Palm Beach analysis. But Miami-Dade's situation has a specific structural vulnerability those counties don't share to the same degree: the complete absence of a D-SNP competitor to Aetna in the current CMS data.

In Broward and Palm Beach, there's at least some D-SNP carrier diversity — meaning if one carrier exits, another may absorb enrollees. In Miami-Dade, based on the 2026 plan data, Aetna is the D-SNP market. That concentration is a 2027 risk that deserves more attention than it's getting.

UnitedHealth Group's two plans in Miami-Dade (R0759_001 at $62/mo and R0759_002 at N/A premium) are Regional PPOs with 3.5-star ratings — and critically, neither is a D-SNP. They offer no Medicaid coordination, no dual-eligible benefit integration. A dual-eligible senior who loses their Aetna D-SNP and "switches" to an AARP Medicare Advantage PPO at $62/month has not found a comparable alternative. They have found a more expensive plan that provides less of what they actually need. (But congratulations on the "choice," I guess.)

What Should Miami-Dade Dual-Eligible Seniors Actually Do Right Now?

I'm not going to recommend a specific plan — that's not what journalism is for, and frankly any recommendation I make today could be outdated by June when carriers submit their 2027 contracts. What I can do is tell you the steps, with the precision of someone who has read too many CMS regulatory documents.

Step 1: Know Your Exact Plan

Look at your Medicare card or your Explanation of Benefits. Find your contract/plan ID — it looks like H1609_017 or similar. Write it down. That alphanumeric string is how CMS tracks whether your plan is being discontinued.

Step 2: Enroll in Medicare.gov Notifications

Create an account at medicare.gov. You can set up alerts tied to your specific plan. When CMS approves or denies a carrier's 2027 filing, that information becomes public. Be the first to know, not the last.

Step 3: Contact Your State Health Insurance Assistance Program (SHIP)

Florida's SHIP is called SHINE (Serving Health Insurance Needs of Elders). It's free, it's unbiased, and counselors speak multiple languages. Call 1-800-963-5337. This call matters more than any TV ad for any Medicare plan.

Step 4: Check Your Medicaid Coordination Status

Florida Medicaid enrollment can be verified at myflorida.com/accessflorida. If your Medicaid eligibility has lapsed (even administratively), your D-SNP eligibility lapses with it. The new CMS Medicaid rules effective January 2027 make this more complex — our coverage of those changes explains the mechanics.

Step 5: Mark October 15 on Your Calendar Like a Tax Deadline

Open Enrollment runs October 15 –