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

In 2026, California Medi-Medi Plans expanded from 12 counties to 41 of the state's 58 counties. 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 and combines both sets of benefits into one plan.,,

The Essentials

A Medi-Medi Plan is an EAE D-SNP. It is a Medicare Advantage plan limited to members who are also enrolled in its affiliated Medi-Cal managed care plan, with care coordination and integrated member materials. 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 in 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. Enhanced Care Management and Community Supports are Medi-Cal managed-care components, and a Medi-Medi Plan combines your Medicare and Medi-Cal benefits in one plan.
Continuity of care is real but conditional. DHCS's 12-month policy covers a member required to move from Medi-Cal fee-for-service into managed care, and only when four conditions hold, including that the provider accepts the plan's contracted or fee-for-service rates. 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 care Medicare does not cover or covers only partly, including nursing home care, personal care, and home- and community-based services. 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. California's model for its duals is 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 13,675,721 certified eligibles in June 2026 per DHCS's Fast Facts report for September 2026 (a count DHCS labels preliminary), and it is administered by the Department of Health Care Services (DHCS).

California built this model against 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:

Your Medicare Part A and B coverage, which the plan must provide, though Original Medicare still helps pay for hospice. Medicare Part D drug coverage is included too, since every Special Needs Plan must carry it.
Supplemental benefits the plan offers, such as fitness programs and some vision, hearing, and dental services.
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 separate: social workers employed by county welfare departments, not your health plan, assess how many service hours you get. The Multipurpose Senior Services Program (MSSP) is a separate Section 1915(c) waiver, not a managed-care benefit, for Medi-Cal members 60 and older who are certified or certifiable for skilled-nursing-facility placement and live in a county with an MSSP site. Your Medi-Medi Plan does not run either program.
Medi-Cal CalAIM benefits, including Enhanced Care Management for eligible members with complex needs and whichever Community Supports your plan offers.

On the Medi-Cal side, outpatient pharmacy stays outside the plan even within Medi-Medi: it is carved out of managed care to fee-for-service Medi-Cal Rx. The carve-out is not total, though: drugs given in a clinic or hospital and billed on a medical or institutional claim stay with your plan.

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 in 2026 they added 29 counties, reaching 41.,

That is a large expansion, but it is neither statewide nor even. In 7 of the new counties (Marin, Napa, Placer, Solano, Sonoma, Yolo, Yuba), DHCS says Medi-Medi Plans are newly available in at least one plan, so your own plan may not offer one. The remaining 17 counties are phased in after 2026, with no Medi-Medi Plan there this year: Butte, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, and Trinity. Confirm your county and your plan on the official DHCS Medi-Medi Plan List, or with Health Care Options, before any enrollment decision.

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 affiliated plans 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 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. The design aims to avoid a Medicare plan paired with an unaligned Medi-Cal plan that uses 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 who stay in Medi-Cal fee-for-service or an unaligned plan cannot use it (being in fee-for-service today is no bar if you are joining the affiliated plan), though they may still use the separate monthly Dual/LIS SEP for Original Medicare plus a standalone Part D plan. It also needs an integrated plan available where you live.

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. The Medi-Cal managed care contracts now in force began January 1, 2024. In a County Organized Health System (COHS) county, DHCS contracts with a county-run plan that is the sole Medi-Cal plan operating there, so the county normally offers one Medi-Cal plan rather than a choice; DHCS's 2026 landscape identifies six COHS plans: Partnership HealthPlan, CalOptima Health, CenCal Health, Central California Alliance for Health, Gold Coast Health Plan, and Health Plan of San Mateo. The exception: Kaiser Permanente holds a separate direct Medi-Cal contract under AB 2724 covering 32 counties, and any dual member living in Kaiser's footprint may enroll in Kaiser's Medi-Cal plan, even in a COHS county.

Rosters change each plan year, so confirm your options through Health Care Options, the statewide enrollment broker, at (800) 430-4263 (TTY (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, Medi-Cal's institutional share-of-cost rules apply: most of her countable income goes toward her care, beyond a personal-needs allowance of at least $35 a month and other allowances state law lists.

CalAIM Benefits Through Your Medi-Medi Plan

Because a Medi-Medi Plan combines Medicare and Medi-Cal benefits into one plan, it is your door to CalAIM. CalAIM is a Section 1115 demonstration plus a parallel Section 1915(b) managed-care waiver, established in California statute by AB 133 (2021), approved by CMS on December 29, 2021 and effective through December 31, 2026. That end date is not necessarily a cliff: DHCS submitted its renewal application to CMS on May 11, 2026, requesting a five-year renewal, which is still a request, not yet an approval. 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, including access to a single Lead Care Manager. Ask your plan whether you qualify.
Community Supports: DHCS describes 14 pre-approved services that plans are encouraged, not required, to offer in full, so which ones you can get varies by plan and county; eligible members can get them whether or not they qualify for ECM. The only reliable roster is your own plan's, so ask your care coordinator which ones it offers and get the answer in writing.
Transitional Rent, added as the fifteenth Community Support effective July 1, 2025, is authorized under the BH-CONNECT waiver rather than CalAIM. It is a room-and-board-only support, capped at a combined 6 months per household per demonstration period. It phases in: under CMS Special Terms and Conditions 10.10, it became optional 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; it becomes mandatory for all eligible populations no sooner than January 1, 2027. So in 2026, plans need not offer it to an older dual outside those access criteria.
Behavioral health coordination continues under the BH-CONNECT demonstration, which CMS approved effective January 1, 2025 through December 31, 2029.

How to Enroll in a Medi-Medi Plan

Step 1

Confirm your county has a Medi-Medi Plan

In 2026, Medi-Medi Plans operate in 41 counties, though in 7 of them it is offered by at least one plan, not necessarily yours;, California has 58, so 17 have none during 2026. 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 gives free, one-on-one Medicare counseling, and HICAP counselors are trained in Medi-Cal as well as Medicare. 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

Call Health Care Options

at 1-800-430-4263, the statewide line for enrolling in or changing a Medi-Cal managed care plan. 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

Know the protection's 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 up to 12 months, and the plan is required to grant the request as long as 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, contact the new plan and name the provider. The plan must answer within 30 calendar days; if it refuses a willing provider or misses that deadline, you can file a grievance with the plan.

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. Two related protections run 90 days: an active prior treatment authorization stays in effect for 90 days after you enroll, and you keep existing durable medical equipment rentals and medical supplies from your current provider for at least 90 days. We have no sourced timeline for prescriptions, so ask about each by name.

Either way, call your new plan soon after enrolling with a list of every provider, prescription, and authorization; 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 from the California Department of Social Services State Hearings Division, toll free at 1-800-743-8525. The deadline depends on who took the action, so check the one printed on your Notice of Action.

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

A Medi-Medi Plan is one option for duals, not the only one. 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 extras a Medicare Advantage plan may add, such as fitness programs, 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: Medi-Medi Plans are the ongoing model that replaced the demonstration, and they are still expanding. Our guide to integrated Medicare-Medicaid plans by state covers other states' versions.

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	Capitated financial-alignment demonstration	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

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. You request continuity of care from the new plan, so each move means making the request again.
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. Medi-Cal pharmacy billed on pharmacy claims runs through fee-for-service Medi-Cal Rx, not your plan, and DHCS says that in most counties dental and substance use disorder treatment may also come through fee-for-service Medi-Cal. Ask your plan which other services it does not cover itself.
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. Plans are encouraged, not required, to offer the full list of Community Supports, and ECM is for eligible members with complex needs, so ask which apply to you and document the answer.

Frequently Asked Questions

Are Medi-Medi Plans mandatory?

No. Under the matching plan policy your Medicare plan choice leads and your Medi-Cal plan follows, but a dual can choose Original Medicare with a standalone Part D plan instead, using the monthly Dual/LIS SEP, or choose a different plan during an enrollment window.

What if I am already in a different plan?

Your Medicare choice still steers your Medi-Cal plan. Under the matching plan policy, being implemented in all counties in 2026, your Medi-Cal plan follows your Medicare plan choice, so a change on the Medicare side can move your Medi-Cal enrollment too. 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 under DHCS's 12-month continuity-of-care policy for members moving from Medi-Cal fee-for-service into managed care, but only if the four conditions above hold. 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; county welfare department social workers assess your hours, so it continues through your county. One thing to watch: IHSS requires living at home or an abode of your own choosing, and an acute care hospital, long-term care facility, or licensed community care facility does not count, so a move into one breaks that rule.

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 California also has coordination-only D-SNPs, which are 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

Medi-Medi Plans are California's integrated option for dual-eligibles. In 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 Community Supports are optional for the plan to offer. Plans are encouraged, not required, to offer all 14 pre-approved Community Supports, so ask which ones yours actually offers.
Continuity of care is conditional, not automatic. The 12-month protection holds only if your provider accepts the plan's rates and three other conditions are met. 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 change your Medi-Cal plan, and confirm which plans serve your county. 1-800-430-4263 healthcareoptions.dhcs.ca.gov

HICAP (Health Insurance Counseling and Advocacy Program) Free, confidential one-on-one Medicare counseling, with counselors trained in Medi-Cal and Medicare. 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.

References

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