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 (MMAI):
The Medicare-Medicaid Alignment Initiative (MMAI) ends Dec 31.
- New Plan Type: You will likely be moved to a FIDE SNP.
- Action: Check if your new plan covers your long-term care providers.
Ohio (MyCare Ohio):
The “Next Generation MyCare” program starts January 1, 2026.
- New Plan Names: Watch for names like “CareSource MyCare Ohio (HMO D-SNP)” or “Wellcare Buckeye MyCare Ohio Dual Align.”
- Automatic: Most members stay with their current carrier but move to the D-SNP version.
Michigan (MI Health Link):
The program is rebranding to “MI Coordinated Health.”
- New Plan Names: Members in plans like MeridianComplete will move to “Wellcare Meridian Dual Align.”
- ID Cards: You should have received a new ID card in December. Start using it Jan 1.
Texas (STAR+PLUS):
Current MMPs end on December 31, 2025.
- Transition: Members are moving to “Wellcare Superior HealthPlan Dual Align” or similar FIDE-SNPs.
- Benefits: These new plans continue to cover nursing facility care and community-based services.
Massachusetts (One Care & Senior Care Options):
- New Plan: Members in the “One Care” program are moving to new “Fully Integrated Dual Eligible (FIDE) SNPs” starting January 1, 2026. Most members will stay with their current carrier (like Commonwealth Care Alliance, Tufts/Point32Health, or UnitedHealthcare) but under a new plan contract.
- Continuity: You can generally keep seeing your current providers for at least 90 days during the transition to ensure your care is not interrupted.
Rhode Island (Integrity):
- New Plan: Members are moving to “Neighborhood INTEGRITY for Duals (HMO D-SNP).”
- Continuity: You can generally keep seeing your current providers for up to 6 months during the transition.
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