California Medi-Medi Plans 2026: The 41-County Expansion, Explained

Effective January 1, 2026, California Medi-Medi Plans expanded from 12 counties to 41 of the state's 58 counties, the largest single-year change in the program's footprint. A Medi-Medi Plan is California's brand for an Exclusively Aligned Enrollment Dual Eligible Special Needs Plan (EAE D-SNP): a Medicare Advantage plan, available only to people enrolled in both Medicare and Medi-Cal, that pairs the Medicare plan with its affiliated Medi-Cal managed care plan so both sets of benefits run through one organization.1,2 This guide explains what a Medi-Medi Plan is, what the 2026 expansion changes, how the matching plan policy decides your carrier, what members receive, how to enroll or opt out, and the continuity-of-care steps every dual-eligible Californian should take before switching plans.

What California Medi-Medi Plans Are: The Federal-State Architecture

People who have both Medicare and Medicaid are "dually eligible." Full-benefit duals have Medicare plus full Medi-Cal; partial-benefit duals have Medicare plus help only through a Medicare Savings Program. Medicare is the primary payer and pays first; Medi-Cal is secondary and can cover Medicare premiums and cost-sharing and pay for services Medicare does not, most importantly long-term custodial care. Anyone who qualifies for Medi-Cal also automatically qualifies for extra federal help with Part D prescription drug costs, without a separate application.4

A Dual Eligible Special Needs Plan (D-SNP) is a type of Medicare Advantage plan, available only to people who also have Medicaid, designed to coordinate the two programs in one plan.4 What varies by state is how deeply that coordination is required. California chose the most integrated form: an Exclusively Aligned Enrollment (EAE) D-SNP, branded the Medi-Medi Plan, which pairs a Medicare Advantage D-SNP with its affiliated Medi-Cal managed care plan for coordinated benefits and integrated member materials.2 Medi-Cal is the country's largest Medicaid program, serving roughly 15 million Californians as of early 2026, administered by the Department of Health Care Services (DHCS).5

California built this model to solve the longest-standing problem in dual coverage: fragmentation. A traditional dual might hold a Medicare Advantage plan at one insurer and a separate Medi-Cal managed care plan at another, leaving two ID cards, two networks, two prior-authorization workflows, two appeal systems, and two care coordinators. The EAE model collapses both sides into one member experience.

When you enroll in a Medi-Medi Plan, you receive:

• All Medicare Part A and B benefits (hospital, doctor visits, skilled nursing facility, hospice) and Medicare Part D drug coverage through the same plan.
• Medicare Advantage supplemental benefits the plan offers, such as transportation, dental, vision, hearing, an over-the-counter allowance, and fitness.
• Medi-Cal long-term services and supports, including In-Home Supportive Services (IHSS) coordination, Community-Based Adult Services (CBAS), Multipurpose Senior Services Program (MSSP) coordination, and nursing-facility coverage.6
• Medi-Cal CalAIM benefits the plan elects to offer, including Enhanced Care Management and Community Supports.3

A few services stay carved out of the plan even within Medi-Medi: outpatient pharmacy runs statewide as fee-for-service Medi-Cal Rx; specialty mental health runs through county mental health plans; substance-use care runs through the county Drug Medi-Cal Organized Delivery System; and most dental runs through Medi-Cal Dental.1

The 2025 to 2026 Expansion: 12 Counties to 41 Counties

The same population was served for years by Cal MediConnect, a federal financial-alignment demonstration that ran from March 2014 through December 31, 2022 and then transitioned into the statewide D-SNP model beginning in 2023.2 Medi-Medi Plans were available in 12 counties in 2024 and 2025, including Los Angeles, Orange, San Diego, Riverside, San Bernardino, Sacramento, and Santa Clara, and then expanded statewide.2

Effective January 1, 2026, Medi-Medi Plans expanded from 12 counties to 41 counties, adding 29 counties across most of the populated parts of the state.1 That leaves 17 of California's 58 counties without a Medi-Medi Plan as of January 1, 2026, concentrated in the rural north and the Sierra. Several fall in the Partnership HealthPlan service area and other rural managed-care regions; DHCS has signaled that remaining counties are expected to phase in after 2026, but launch dates are not yet final. Confirm whether your county has a Medi-Medi Plan, and which plans serve it, on the official DHCS Medi-Medi Plan List before you make any enrollment decision.

The practical takeaway: in 2026, most full-benefit dual-eligible Californians live in a county where a Medi-Medi Plan is available, and the matching plan policy shapes how their Medicare and Medi-Cal coverage fit together.

The Matching Plan Policy: How Your Carrier Is Decided

The administrative anchor of the program is DHCS's matching plan policy: in a Medi-Medi county, your Medicare plan leads and your affiliated Medi-Cal managed care plan follows, so the two enrollments stay with the same parent organization rather than splitting across competing carriers.2 DHCS sets this direction through its All Plan Letters, and explains it for members on its Matching Plan Policy page for duals.

In practice, that means if you choose Anthem's Medicare Advantage D-SNP in a matching county, your Medi-Cal benefits route through the affiliated Anthem Medi-Cal plan; if you choose Kaiser's D-SNP, you get Kaiser on the Medi-Cal side. The two enrollments are not split between different carriers in these counties. This removes the most disruptive scenario in legacy dual coverage: choosing a strong Medicare plan but being stuck with an unaligned Medi-Cal plan that uses different doctors, formularies, and prior-authorization rules.

Federal enrollment rules reinforce the alignment. Effective January 1, 2025, CMS created a monthly Integrated Care SEP that lets a full-benefit dual enroll once per month into a fully integrated D-SNP, highly integrated D-SNP, or applicable integrated plan, with an effective date of the first of the next month. That SEP is available only to facilitate aligned enrollment: you must be enrolled in, or enrolling in, the Medi-Cal managed care plan affiliated with the integrated D-SNP you are joining. Duals who stay in Medi-Cal fee-for-service or an unaligned plan cannot use it, though they may still use the separate monthly dual-eligible drug-plan SEP to elect Original Medicare plus a standalone Part D drug plan.7 In other words, the once-a-month switch into a fully integrated plan is reserved for duals who are aligned, which is exactly what the California matching plan policy is built to produce.

Which California Medi-Medi Plans Serve Your County

DHCS publishes the authoritative, county-by-county roster in its 2026 Medi-Medi Plan List, and the carriers available depend on which Medi-Cal managed care plans operate in your county.1 In Los Angeles County, the state's largest dual-eligible market, multiple carriers offer Medi-Medi Plans, including Anthem, Blue Shield of California, Kaiser Permanente, L.A. Care, Molina, SCAN, and Health Net/Wellcare. In counties run as a County Organized Health System, a single county-run plan is the sole Medi-Cal carrier, so the Medi-Medi options are tied to that one plan rather than several competitors.1

Because rosters change each plan year and vary by county, confirm your current options through Health Care Options at 1-800-430-4263 before enrolling, or get free, unbiased help from a HICAP counselor at 1-800-434-0222. Dual-eligibles have more frequent enrollment opportunities than the general Medicare population, but California advocates discourage frequent switching because each change can restart your continuity-of-care protections.

What Members Experience: Before and After

Consider a 72-year-old Sacramento resident with early-stage dementia and Type 2 diabetes.

Before, under fragmented coverage, she carries two ID cards, has two care coordinators who rarely share records, files separate Medicare and Medi-Cal grievances when a service is denied, and navigates two prior-authorization systems, one for a Medicare-covered CT scan and another for a Medi-Cal-covered home modification.

After enrolling in a Medi-Medi Plan, she carries one ID card, has one care coordinator with visibility into both Medicare and Medi-Cal benefits, sees providers who are in-network for both sides by definition, and files a single grievance through one process.4 When she later needs nursing-facility care, the same plan manages the transition, including the Medi-Cal long-term-care benefit and the share-of-cost calculation that applies to institutional Medi-Cal in California.8

The goal of the model is coordination: one organization accountable for both programs, instead of two plans pointing at each other over who covers durable medical equipment, transportation, or behavioral health.

CalAIM Benefits Through Your Medi-Medi Plan

Because a Medi-Medi Plan also holds the Medi-Cal managed care contract, it is your door to CalAIM. CalAIM is a Section 1115 demonstration plus a Section 1915(b) managed-care waiver, authorized by AB 133 (2021), approved December 29, 2021 and effective through December 31, 2026.3 Its core managed-care components reach dual-eligible members directly:

• Enhanced Care Management (ECM) is a statewide Medi-Cal benefit for members with complex needs, organized around defined Populations of Focus and delivered by a single Lead Care Manager. Older adults at risk of nursing-facility admission, members with serious mental illness, and members experiencing homelessness are among the groups served.3
• Community Supports are 14 pre-approved services that Medi-Cal plans may elect to offer in lieu of standard services. The ones most relevant to older duals include recuperative care, personal care and homemaker services, respite for family caregivers, medically tailored meals, nursing-facility transition and diversion, environmental accessibility adaptations, and housing-related supports.3
• Transitional Rent is a fifteenth Community Support, the first Section 1115 Medicaid benefit to cover direct rent; it was optional for plans starting January 1, 2025 and became required for all Medi-Cal managed care plans on January 1, 2026.3
• Behavioral health coordination continues under the BH-CONNECT demonstration, effective January 1, 2025, with specialty mental health and substance-use care delivered through county systems.3

Community Supports are optional for plans to offer, so ask your care coordinator directly which ones your plan provides.

How to Enroll in a Medi-Medi Plan

Continuity of Care: Your Rights During a Transition

When you move into a Medi-Medi Plan from a different plan or from fee-for-service coverage, Medi-Cal continuity-of-care rules are designed to prevent disruption to care already underway. Under those rules, you can generally:

• Keep an established out-of-network provider for a transition period (commonly up to 12 months) if you have an existing relationship with that provider.
• Continue an active treatment authorization for a continuation period, including ongoing specialty care and therapy.
• Maintain ongoing prescriptions and medical equipment through the plan's standard transition process.

Exact timelines and rules are set by your plan and DHCS, so confirm them directly. The single most important step is to call your new plan soon after enrollment and submit a continuity-of-care request that lists every provider, specialist, prescription, and authorization currently in place. For the official rules and current timelines, see the DHCS Continuity of Care FAQ. If the plan denies a request, you can file a grievance and request a state hearing.

Opt-Out: If You Do Not Want a Medi-Medi Plan

Enrollment in any specific Medi-Medi Plan is voluntary. You can:

• Stay in Original Medicare instead of choosing a Medicare Advantage plan, in which case your Medi-Cal coverage continues separately. This is the way to remain outside the aligned-enrollment framework in a Medi-Medi county.
• Switch to a different Medi-Medi Plan or change coverage during the enrollment windows available to you. Full-benefit duals have monthly switching options, but the integrated-plan SEP applies only to aligned enrollment.7

Weigh the trade-off carefully. Original Medicare does not include the supplemental benefits, such as transportation, dental, and over-the-counter allowances, that Medi-Medi Plans typically provide, and you lose the single-plan coordination the matching policy is designed to deliver. Many California elder-care advocates, including CANHR and Justice in Aging, treat integrated enrollment as the sensible default unless there is a specific clinical or geographic reason to stay in Original Medicare.

How Medi-Medi Plans Differ From Cal MediConnect

For Californians who remember the predecessor program, Medi-Medi Plans look similar but rest on a different legal foundation. Cal MediConnect was a time-limited federal financial-alignment demonstration that ended December 31, 2022; Medi-Medi Plans operate under permanent D-SNP authority paired with California's matching plan policy under CalAIM.2 The two practical improvements are durability, because D-SNP authority is not set to sunset the way the demonstration was, and broader carrier choice in the largest counties.

Common Pitfalls

1. Skipping the continuity-of-care request. This is the most common source of post-transition disruption. Call your new plan soon after enrollment and list every provider, prescription, and authorization in place.
2. Switching plans too often. Duals have generous switching rights, but each change can restart your continuity-of-care clock. Choose carefully.
3. Confusing aligned enrollment with no choice. Alignment defaults your Medi-Cal carrier when you pick a Medicare plan, but you can still choose a different Medi-Medi Plan during an enrollment window.
4. Assuming every Medicare provider is in the network. A Medi-Medi network must serve both the Medicare and Medi-Cal sides, so verify each provider before transitioning.
5. Forgetting that some benefits are carved out. Outpatient pharmacy runs through Medi-Cal Rx, and specialty behavioral health and most dental run through separate county or statewide programs.1
6. Not coordinating IHSS. Tell your plan your IHSS hours and provider so the care coordinator can work with your county social worker.
7. Missing Community Supports. They are optional for plans, so ask your coordinator which ones your plan offers and document the answer.3
8. Not asking about ECM eligibility. Many older duals qualify for Enhanced Care Management and do not know it. Ask directly.3

The Bottom Line

If you remember nothing else, remember these points:

1. Medi-Medi Plans are California's integrated option for dual-eligibles. As of January 1, 2026, 41 of 58 counties have them.1
2. Integration solves fragmentation. One ID card, one care coordinator, one network, one grievance process.
3. CalAIM benefits flow through your plan. Enhanced Care Management and Community Supports come from the same organization as your Medicare coverage.3
4. Continuity of care is your main protection. Submit a request to your new plan soon after enrolling so existing providers and prescriptions carry over.
5. You still have choices. Aligned enrollment defaults your carrier, but you can switch plans or choose Original Medicare during the windows available to you.7

Where to Get Help

Learn More

Find personalized help comparing your Medi-Medi Plan options at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.