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., 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.

The Essentials

A Medi-Medi Plan is an EAE D-SNP. You enroll once, with one company, and receive your Medicare benefits and your Medi-Cal benefits through the same plan, with one care coordinator and one affiliated Medi-Cal managed care plan. To join, you need Medicare Part A and Part B plus Medi-Cal, and you must be 21 or older.
2026 expansion: Medi-Medi Plans grew from 12 counties (2024–2025) to 41 counties effective January 1, 2026, adding 29 counties.
The matching plan policy is the anchor: your Medicare plan choice leads and your Medi-Cal plan follows. It applied in 17 counties in 2025 and is being implemented in all counties in 2026, so it is broader than the 41-county Medi-Medi footprint.
CalAIM benefits flow through your plan. Because the Medi-Medi Plan also holds the Medi-Cal managed care contract, Enhanced Care Management and Community Supports are delivered by the same organization as your Medicare coverage.
Continuity of care is real but conditional. DHCS's 12-month continuity-of-care policy covers a member required to move from Medi-Cal fee-for-service into a managed care plan, and it applies only if you already have a relationship with that provider, the plan has no quality-of-care concerns about them, the provider accepts the plan's contracted or fee-for-service rates, and the provider is a California State Plan approved provider. Contact your new plan and name the provider to start it.

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. Extra Help, the federal Part D low-income subsidy, comes automatically, without a separate application, to people with full Medicaid coverage, to people whose state pays their Part B premium through a Medicare Savings Program, and to SSI recipients.

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. 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. Medi-Cal is one of the nation's largest and most complex Medicaid systems, with 13,910,180 certified eligibles in April 2026 per DHCS's Fast Facts report, and it is administered by the Department of Health Care Services (DHCS).

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 Medi-Cal plan at another, leaving two networks, two prior-authorization workflows, and two care coordinators. When you enroll in a Medi-Medi Plan, you get:

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.
Community-Based Adult Services (CBAS), which DHCS describes as a Medi-Cal managed care benefit for eligible members enrolled in Medi-Cal managed care, so it is delivered by your plan. Nursing-facility care is covered on the Medi-Cal side as well, subject to the institutional share-of-cost rules.
Coordination with the programs that stay outside the plan. In-Home Supportive Services (IHSS) is administered by the California Department of Social Services with intake, eligibility, and assessment carried out by the 58 county welfare departments, not by your health plan. The Multipurpose Senior Services Program (MSSP) is a Section 1915(c) waiver delivered through local agencies under contract with the California Department of Aging, again separate from managed care. Your Medi-Medi Plan coordinates around both; it does not run them.
Medi-Cal CalAIM benefits the plan elects to offer, including Enhanced Care Management and Community Supports.

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.

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. Medi-Medi Plans were available in 12 counties in 2024 and 2025, and effective January 1, 2026 they added 29 counties, reaching 41.

That is a large expansion, but it is not statewide. California has 58 counties, so 17 still have no Medi-Medi Plan. We do not have a sourced list of which 17, or a published launch date for any of them, so do not assume your county is or is not covered: confirm it on the official DHCS Medi-Medi Plan List, or by calling Health Care Options, before you make any enrollment decision.

The practical takeaway: whether or not a Medi-Medi Plan operates in your county, the matching plan policy is what shapes how your Medicare and Medi-Cal coverage fit together in 2026.

The Matching Plan Policy: How Your Carrier Is Decided

The administrative anchor of the program is DHCS's matching plan policy: your Medicare plan choice 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. Note the reach. The matching plan policy applied in 17 counties in 2025 and is being implemented in all counties in 2026, which is a wider footprint than the 41 counties that have a Medi-Medi Plan. DHCS sets this direction through its All Plan Letters, and explains it for members on its Matching Plan Policy page for duals.

In practice: choose a carrier's Medicare Advantage D-SNP and your Medi-Cal benefits are meant to route through that same carrier's affiliated Medi-Cal plan rather than a competitor's. That removes the most disruptive scenario in legacy dual coverage, a strong Medicare plan paired with an unaligned Medi-Cal plan using different doctors and prior-authorization rules. Which carriers actually pair up where you live depends on which Medi-Cal plans hold contracts in your county, so confirm the pairing with Health Care Options rather than assuming it.

Federal enrollment rules reinforce the alignment. Effective January 1, 2025, CMS created a monthly Integrated Care SEP letting a full-benefit dual elect a fully integrated D-SNP, highly integrated D-SNP, or applicable integrated plan once per month, effective the first of the next month. It is available only to facilitate aligned enrollment: you must be in, or joining, the Medi-Cal managed care plan affiliated with that D-SNP. Duals in Medi-Cal fee-for-service or an unaligned plan cannot use it, though they may still use the separate monthly Dual/LIS SEP for Original Medicare plus a standalone Part D plan.

Which California Medi-Medi Plans Serve Your County

DHCS publishes the authoritative, county-by-county roster in its 2026 Medi-Medi Plan List. Because a Medi-Medi Plan has to pair with an affiliated Medi-Cal managed care plan, the carriers available to you depend on which Medi-Cal plans hold contracts in your county. California's 2024 statewide procurement, effective January 1, 2024, awarded five commercial Medi-Cal plans: Blue Cross of California Partnership Plan (Anthem), Blue Shield of California Promise Health Plan, Community Health Group Partnership Plan, Health Net Community Solutions, and Molina Healthcare of California. Kaiser Permanente holds a separate direct Medi-Cal contract under AB 2724 and SB 510, serving 32 counties. In counties run as a County Organized Health System, DHCS contracts with a single county-run plan that is the sole Medi-Cal plan in the county, and members there have no Medi-Cal plan choice at all; six COHS plans (Partnership HealthPlan, CalOptima, CenCal Health, Central California Alliance for Health, Gold Coast Health Plan, and Health Plan of San Mateo) cover 22 counties.

We do not publish a per-county carrier list here, because rosters change each plan year. Confirm your options through Health Care Options, the statewide enrollment broker, at 1-800-430-4263 (TTY 1-800-430-7077), Monday through Friday, 8 a.m. to 6 p.m., or get free help from a HICAP counselor at 1-800-434-0222. On the Medi-Cal side, 42 CFR 438.56(c) sets the floor: a state that limits disenrollment must allow it for cause at any time, without cause during the 90 days after enrollment (or after the state's notice of it, whichever is later), and without cause at least once every 12 months after that.

What Members Experience: Before and After

Consider a 72-year-old Sacramento resident with early-stage dementia and Type 2 diabetes. Before, she holds a Medicare Advantage plan at one insurer and a Medi-Cal plan at another, with two care coordinators who rarely share records and two prior-authorization systems.

After enrolling in a Medi-Medi Plan, her two enrollments sit with affiliated organizations, and DHCS describes the model as providing care coordination and integrated member materials. That is what a D-SNP is built to do: coordinate the delivery of both programs' services in one plan. Ask any plan you are weighing how many ID cards you will carry, whether grievances run through one process, and whether your own doctors are in-network on both sides, because those details are set by the plan, not guaranteed by the model. If she later needs nursing-facility care, that plan manages the transition, including the institutional share-of-cost calculation.

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 parallel Section 1915(b) managed-care waiver, established in state law by AB 133 (2021), approved by CMS on December 29, 2021 and effective through December 31, 2026. That end date is not a cliff you should plan around alone: DHCS submitted its renewal application to CMS on May 11, 2026, seeking a five-year renewal through December 31, 2031. Its core managed-care components reach dual-eligible members directly:

Enhanced Care Management (ECM) is a statewide Medi-Cal benefit for eligible members with complex needs, organized around defined ECM Populations of Focus and delivered by a single Lead Care Manager. Ask your plan whether you meet one of its Populations of Focus; that is the gate, and plans do not always volunteer it.
Community Supports are 14 pre-approved services (formerly called In Lieu of Services) that Medi-Cal managed care plans may elect to offer in place of standard State Plan services. Because election is the plan's choice, the only reliable roster is your own plan's, so ask your care coordinator which of the 14 it offers and get the answer in writing.
Short-term rental assistance, which DHCS has also called Transitional Rent, provides up to six months of rent or temporary housing. Its authority and schedule come from the BH-CONNECT demonstration, not from the Community Supports list, and it phases in rather than switching on. Under CMS Special Terms and Conditions 10.10, it became an optional service for plans no sooner than July 1, 2025; no sooner than January 1, 2026 it is mandatory only for people who meet the access criteria for Medi-Cal specialty mental health services, Drug Medi-Cal, or the Drug Medi-Cal Organized Delivery System, and remains optional for everyone else; it becomes mandatory for all eligible populations no sooner than January 1, 2027. So in 2026, an older dual who does not meet those behavioral-health access criteria has no entitlement to it.
Behavioral health coordination continues under the BH-CONNECT demonstration, which CMS approved effective January 1, 2025 through December 31, 2029, with specialty mental health and substance-use care delivered through county systems.

How to Enroll in a Medi-Medi Plan

Step 1

Confirm your county has a Medi-Medi Plan

As of January 1, 2026, Medi-Medi Plans operate in 41 counties; California has 58, so 17 do not have one. Check the official DHCS Medi-Medi Plan List, or call Health Care Options, before you make any enrollment decision.

Step 2

Get free counseling first

A HICAP counselor compares your county's plans at no cost and can flag how each handles your current doctors and prescriptions. Reach HICAP at 1-800-434-0222.

Step 3

Check the network before you choose

Confirm your doctors, specialists, and pharmacies are in the plan's combined Medicare and Medi-Cal network.

Step 4

Enroll through Health Care Options

at 1-800-430-4263. Under the matching plan policy, choosing the Medicare plan aligns your Medi-Cal plan to the same organization.

Step 5

Submit a continuity-of-care request right away

, listing every provider, prescription, and active authorization.

Continuity of Care: Your Rights During a Transition

The protection people mean when they say "continuity of care" is specific, and it is worth knowing its exact shape before you rely on it. Under DHCS continuity-of-care policy, a member required to transition from Medi-Cal fee-for-service into a managed care plan may keep seeing their existing fee-for-service provider for 12 months, but only if all four of these hold:

You already have a current relationship with that provider.
The plan has no quality-of-care concerns about that provider.
The provider will accept the plan's contracted rates or fee-for-service rates.
The provider is a California State Plan approved provider.

To start it, you contact the new plan and name the provider.

Two cautions. The rate condition is where families get surprised: a provider who will not accept the plan's rates is not carried over, however long the relationship. And this 12-month rule is written for the fee-for-service-to-managed-care move, so if you are switching between managed care plans, ask your new plan in writing what applies to you rather than assuming the same 12 months. We have no sourced timeline for prescriptions, durable medical equipment, or an in-flight authorization, so ask about each by name.

Either way, call your new plan soon after enrollment and submit a request listing every provider, prescription, and authorization in place; the DHCS Continuity of Care FAQ carries the official rules. If the plan denies it, complain to the plan first; a member still not satisfied can call the State Office of the Ombudsman at 1-888-452-8609, and a Medi-Cal State Hearing is requested through the Public Inquiry and Response Unit at 1-800-952-5253.

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. A dual who does this can still use the monthly Dual/LIS SEP to pick or change a standalone Part D drug plan.
Switch to a different Medi-Medi Plan or change coverage during the enrollment windows available to you. The Integrated Care SEP is a once-a-month election, but it is open only to full-benefit duals (QMB+, SLMB+, FBDE), not partial-benefit duals or Extra Help-only enrollees, and it must be used to align with the affiliated Medi-Cal plan. Neither monthly SEP lets you enroll in or switch between non-D-SNP Medicare Advantage plans; for those you use your Initial Enrollment Period, the Annual Enrollment Period, the Medicare Advantage Open Enrollment Period, or another applicable SEP.

Weigh the trade-off. Original Medicare does not carry the supplemental benefits a Medicare Advantage plan may offer, and you give up the coordination the aligned model is built to deliver. The answer turns on your own doctors and your own care, so talk it through with a free HICAP counselor; CANHR and Justice in Aging also publish California-specific material on dual coverage.

How Medi-Medi Plans Differ From Cal MediConnect

Medi-Medi Plans look similar to the predecessor program but rest on a different legal foundation. Cal MediConnect was a time-limited federal financial-alignment demonstration that ended December 31, 2022; beginning in 2023 it was replaced by California's statewide exclusively aligned D-SNP infrastructure, paired with the matching plan policy under CalAIM. The practical difference is durability: D-SNP authority is not a demonstration with a scheduled end date.

Dimension	Cal MediConnect (2014–2022)	Medi-Medi Plans (2023 onward)
Federal authority	Financial alignment demonstration	D-SNP authority plus state matching plan policy
Plan model	Three-way demonstration contract	EAE D-SNP with exclusively aligned Medicare and Medi-Cal enrollment
Counties	Demonstration counties only	41 counties as of 2026
End of program	Ended December 31, 2022	Ongoing program in an expansion phase
Long-term services	Delivered through the plan	CBAS and nursing-facility care through the plan; IHSS and MSSP stay outside it

Common Pitfalls

Skipping the continuity-of-care request, or assuming it is automatic. Call your new plan soon after enrollment, list every provider and authorization, and confirm your provider will accept the plan's rates. That last condition is the one that quietly defeats the protection.
Switching plans too often. A continuity-of-care arrangement is tied to the plan you are in, so each move means starting the request over.
Assuming every Medicare provider is in the network. A Medi-Medi network has to serve both the Medicare and the Medi-Cal side, so verify each provider before transitioning.
Forgetting that some benefits are carved out. Outpatient pharmacy runs statewide through fee-for-service Medi-Cal Rx, specialty mental health through county Mental Health Plans, substance-use care through the county DMC-ODS, and most dental through Medi-Cal Dental.
Assuming the plan runs IHSS. It does not. Tell your plan your IHSS hours and provider so the coordinator can work with your county social worker.
Not asking about Community Supports and ECM by name. Community Supports are optional for plans to elect, and ECM is gated on defined Populations of Focus, so ask which apply to you and document the answer.

Frequently Asked Questions

Are Medi-Medi Plans mandatory?

No. Enrollment in any specific Medi-Medi Plan is voluntary. Under the matching plan policy your Medicare plan choice leads and your Medi-Cal plan follows to the affiliated organization, but you can choose Original Medicare instead, or switch to a different Medi-Medi Plan during an enrollment window.

What if I am already in a different plan?

Existing members are generally not forced to move immediately. Compare Medi-Medi Plans during your enrollment window and confirm your current options with Health Care Options before deciding.

Does my doctor need to be in the Medi-Medi network?

For new care, generally yes. An existing provider may carry over, but the protection is conditional, not automatic: DHCS's 12-month continuity-of-care policy covers a member moving from Medi-Cal fee-for-service into managed care, and it requires a current relationship, no quality-of-care concerns, the provider's acceptance of the plan's contracted or fee-for-service rates, and California State Plan approved status. Submit the request to your new plan soon after enrolling and ask them to confirm in writing.

Will my IHSS be affected?

Your Medi-Medi Plan does not run IHSS. It is administered by the California Department of Social Services, with intake, eligibility, and assessment handled by the 58 county welfare departments, so it continues through your county. One thing to watch: IHSS eligibility requires that you live in your own home, and facility residents are not eligible, so if the enrollment is part of a move into a facility, IHSS ends with the move.

Can I have Medicare Advantage and Medi-Cal but not be in a Medi-Medi Plan?

Yes, in the sense that not every Medicare Advantage plan is a Medi-Medi Plan; a Medi-Medi Plan is specifically an EAE D-SNP, and a coordination-only D-SNP is a different thing. But the matching plan policy is being implemented in all counties in 2026, and it is designed to make your Medi-Cal plan follow your Medicare plan choice, so ask Health Care Options what a specific Medicare plan would do to your Medi-Cal enrollment before you sign anything.

The Bottom Line

If you remember nothing else, remember these points:

Medi-Medi Plans are California's integrated option for dual-eligibles. As of January 1, 2026, they operate in 41 counties, out of California's 58.
The matching plan policy is wider than the plans. It applied in 17 counties in 2025 and is being implemented in all counties in 2026, so it can shape your Medi-Cal enrollment even where no Medi-Medi Plan operates.
CalAIM benefits flow through your plan, but most are optional for the plan to offer. Community Supports are 14 services a plan may elect to provide, so ask which ones yours actually offers.
Continuity of care is conditional, not automatic. The 12-month protection requires a current relationship, no quality-of-care concerns, the provider's acceptance of the plan's rates, and State Plan approved status. Submit the request early and get the answer in writing.
You still have choices, within limits. The monthly Integrated Care SEP is for full-benefit duals aligning with the affiliated Medi-Cal plan; it is not a general licence to switch Medicare Advantage plans.

Where to Get Help

Health Care Options Enroll in or switch a Medi-Medi Plan, and confirm which plans serve your county. 1-800-430-4263 healthcareoptions.dhcs.ca.gov

HICAP (Health Insurance Counseling and Advocacy Program) Free, unbiased Medicare and Medi-Medi Plan counseling for California seniors. 1-800-434-0222 aging.ca.gov/Programs_and_Services/Medicare_Counseling

DHCS Medi-Medi Plan List The official, county-by-county roster of Medi-Medi Plans. www.dhcs.ca.gov/services/Pages/Medi-Medi-Outreach.aspx

Learn More

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

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