Important news for Medicare-Medicaid coverage in 2026…
The Medicare–Medicaid Plan (MMP) demonstration is ending after more than a decade, affecting roughly 235,000 dual-eligible members across 12 states.
In some states, CMS will automatically move members into new integrated D-SNPs with the same insurance company to keep coverage seamless.
But in states without successor plans, members will need to actively choose a new plan during the 2026 Annual Enrollment Period (AEP) to avoid a gap in coverage.
Here’s everything you need to know…
What’s Happening
CMS launched MMPs in 2011 as part of the Financial Alignment Initiative. MMPs are specialized plans for people who qualify for both Medicare and Medicaid, combining benefits from both programs under one plan to improve care coordination and simplify coverage.
These plans were designed to:
- Combine Medicare and Medicaid features under a single plan
- Improve care coordination
- Simplify coverage for people eligible for both programs
The demonstration has been conducted in 12 states and involved over 230,000 members.
Starting January 1, 2026, MMPs will be replaced by integrated Dual Eligible Special Needs Plans (D-SNPs), which are Medicare Advantage plans tailored for people eligible for both Medicare and Medicaid.
D-SNPs coordinate benefits from both programs, helping members access care more easily while covering Medicare services and Medicaid benefits in a single plan.
States and Members Affected
| State | MMP Members | Total MA Members | % of MA Enrollment |
| Illinois | 75,500 | 773,055 | 10% |
| Ohio | 52,432 | 1,163,925 | 5% |
| Massachusetts | 39,385 | 477,408 | 8% |
| Michigan | 31,364 | 915,594 | 3% |
| Texas | 14,064 | 2,116,678 | 1% |
| Rhode Island | 11,740 | 137,732 | 9% |
| South Carolina | 7,557 | 505,926 | 1% |
| New York | 1,687 | 1,768,374 | 0% |
| Other States | 1,672 | 644,751 | 0% |
| Total | 233,851 | 9,502,559 | 2% |
How the Transition Will Work
Illinois:
- The state plans to move people into a new kind of combined plan in 2026.
- More services, like long-term care, will likely be added in 2027.
- If you are in an older plan, you may need to pick a new one.
Ohio:
- A new program will start on January 1, 2026.
- Some plans may stay the same, and some may change.
- If your plan is not offered, the state may place you in a new one. You can choose something else if you want.
Massachusetts:
- Programs for adults ages 21-64 and for people 65+ will likely move into new combined plans.
- You may get a notice with your choices for 2026.
Michigan:
- A new program will start on January 1, 2026.
Rhode Island:
- People in the current combined plan will move to a new combined plan.
- You may get a new ID card and can choose a different plan if you prefer.
Texas:
- The current program is scheduled to end on December 31, 2025.
- New combined plans will start on January 1, 2026.
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