If your Illinois MMAI plan was from Aetna, Humana, Meridian or Molina, the default was automatic enrollment by CMS in that company's new plan on January 1, 2026. That plan is a fully integrated dual eligible special needs plan (FIDE SNP). You could instead choose other coverage, including another FIDE SNP, starting October 15, 2025. Illinois's Medicare-Medicaid Alignment Initiative (MMAI) demonstration ended December 31, 2025, and since January 1, 2026 the FIDE SNP has been the only dual eligible special needs plan model in Illinois, offered in every county. Four companies offer an Illinois FIDE SNP in 2026: Aetna, Humana, Molina and Wellcare Meridian. Blue Cross Blue Shield did not offer an Illinois FIDE SNP for 2026.

In This Guide

What an Illinois FIDE SNP Is

A FIDE SNP is a Medicare Advantage plan for people who have both Medicare and Medicaid. It is one kind of dual eligible special needs plan (D-SNP). The Illinois Department of Healthcare and Family Services (HFS) says that beginning January 1, 2026 it offers Medicare Advantage D-SNPs, and the FIDE SNP is the only D-SNP model available in Illinois. The Centers for Medicare & Medicaid Services (CMS) contract year 2026 integration-status file lists Illinois among the states with FIDE SNPs, and not among the states with highly integrated (HIDE) SNPs or coordination-only D-SNPs.

In practice, one plan handles both programs. According to HFS, an Illinois FIDE SNP covers all Medicare and Medicaid benefits, including primary and acute care, behavioral health services and long-term services and supports. Each FIDE SNP gives a member one care coordinator for both programs, one health risk assessment, one appeal and grievance process and a single member ID card. The FIDE SNP replaced Illinois's MMAI demonstration, which ended December 31, 2025. How the federal integration tiers differ from one another is covered in our national guide to fully integrated dual eligible special needs plans.

Illinois chose its four FIDE SNPs through a competitive procurement. The plans offered from January 1, 2026 are:

  • Aetna Medicare FIDE (HMO D-SNP)
  • Humana Dual Fully Integrated (HMO D-SNP)
  • Molina Medicare Complete Care Plus (HMO D-SNP)
  • Wellcare Meridian Dual Align (HMO D-SNP)

HFS lists the four plans on its FIDE SNP program page.

If You Were in an MMAI Plan

The default for an Illinois MMAI member on January 1, 2026 depended on which company ran the plan. Members could instead choose other coverage, including another FIDE SNP, starting October 15, 2025.

Your 2025 MMAI company Default on January 1, 2026
Aetna Automatic enrollment by CMS in Aetna Medicare FIDE (HMO D-SNP)
Humana Automatic enrollment by CMS in Humana Dual Fully Integrated (HMO D-SNP)
Meridian Automatic enrollment by CMS in Wellcare Meridian Dual Align (HMO D-SNP)
Molina Automatic enrollment by CMS in Molina Medicare Complete Care Plus (HMO D-SNP)
Blue Cross Blue Shield No FIDE SNP offered for 2026

Being moved automatically does not lock you in. HFS's FIDE SNP presentation says FIDE SNP enrollment is voluntary and that members who were auto-enrolled, or who chose to enroll, can disenroll at any time. The sections on switching and on what happens if you leave explain the options.

Who Qualifies for an Illinois FIDE SNP, and Who Doesn't

HFS sets five conditions. To join an Illinois FIDE SNP, you must:

  • Receive full Illinois Medicaid benefits and be enrolled in either the Aid to the Aged, Blind, and Disabled (AABD) or the FamilyCare category of assistance
  • Be 21 or older at the time of enrollment
  • Have Medicare Part A and Part B
  • Live in the plan's service area
  • Be a United States citizen or lawfully present in the United States

HFS says these groups are not eligible to enroll in an Illinois FIDE SNP:

  • People under age 21
  • People receiving developmental disability institutional services, or participating in the HCBS waiver for Adults with Developmental Disabilities
  • People in the Medicaid spend-down population
  • People in the Illinois Medicaid Breast and Cervical Cancer program
  • People enrolled in partial-benefit Medicaid programs
  • People receiving comprehensive third-party insurance

HFS's FIDE SNP model contract also bars plans from enrolling people who are enrolled in the PACE program. HFS's FIDE SNP presentation notes that these eligibility rules are the same as MMAI's.

If you aren't sure which Illinois Medicaid category you're in, our guide to Illinois Medicaid income and asset limits covers the state's financial rules, and our guide to help paying Medicare premiums in Illinois covers the state programs for Medicare costs.

FIDE SNP vs. MMAI vs. Other Medicare Advantage Plans

HFS publishes its own comparison of MMAI plans, FIDE SNPs and Medicare Advantage plans that are not FIDE SNPs. The table below follows it.

Feature MMAI plan (ended 2025) Illinois FIDE SNP Medicare Advantage plan that isn't a FIDE SNP
Benefits covered All Medicare and Medicaid benefits All Medicare and Medicaid benefits, including long-term services and supports Medicare benefits only
One care coordinator for both programs Yes Yes No
One health risk assessment Yes Yes No
One appeal and grievance process Yes Yes No
Single member ID card Yes Yes No
Continuity-of-care period No less than 90 days No less than 90 days No less than 90 days
Prescription drug copays $0 $0 with waiver or nursing home services; otherwise up to $5.10 generic and $12.65 brand-name, then $0 after $2,100 in total drug costs Same as a FIDE SNP, per HFS

Two rows in that table need more explanation. The unified appeal process lets a FIDE SNP member file a single appeal or complaint with the plan whether a service is covered by Medicare, Medicaid or both. During the continuity-of-care period, the plan covers the services the member is already receiving.

Drug copays changed from MMAI. MMAI plans offered $0 copays. HFS says FIDE SNP members pay $0 if they receive waiver or nursing home services and very small copayments otherwise, because members qualify for Extra Help. In calendar year 2026, Extra Help copays are up to $5.10 for a generic drug and up to $12.65 for a brand-name drug, and once total drug costs, including copays, reach $2,100, the member pays $0 for each covered drug.

Each Illinois FIDE SNP has a provider network members must use. HFS tells members to call the FIDE SNP or check its provider directory to see whether a doctor is in network. This guide doesn't cover individual plan premiums, extra benefits or star ratings; compare those on Medicare.gov or ask the plan directly.

How to Join or Switch an Illinois FIDE SNP

Illinois FIDE SNP enrollment runs through the plan, not the state: HFS's presentation says the FIDE SNP, not HFS, enrolls or disenrolls members. HFS describes three ways to enroll:

1
Step 1

Search plans on Medicare.gov

Use Medicare.gov's plan search, and select "Medicaid" when it asks whether you get help with Medicare health or drug costs.

2
Step 2

Contact the plan

Call the FIDE SNP or visit its website. HFS's FIDE SNP page names the four plans.,

3
Step 3

Call 1-800-MEDICARE

The number is 1-800-633-4227 (TTY 1-877-486-2048).

Timing depends on which enrollment period you use. HFS describes three for Illinois dual eligibles:

Enrollment period When What it lets you do When coverage starts
Integrated Care Special Enrollment Period Once per month Enroll in a FIDE SNP, if you're eligible for one First of the month after the plan gets the request
Dual/LIS Special Enrollment Period Once per month Leave a Medicare Advantage plan (including a FIDE SNP) for Original Medicare and a standalone drug plan, or switch between standalone drug plans First of the month after the plan gets the disenrollment request
Open Enrollment Period October 15 to December 7 each year Join, drop or switch Medicare Advantage plans January 1 of the next year

Neither monthly special enrollment period lets you join a Medicare Advantage plan that is not a D-SNP, or switch between Medicare Advantage plans that are not D-SNPs. If you want a regular Medicare Advantage plan, the Open Enrollment Period is the window HFS describes.

If You Don't Join a FIDE SNP

You can stay out of an Illinois FIDE SNP, or leave one. HFS lists two Medicare options for dual eligibles who don't choose a FIDE SNP: return to Original Medicare with a Medicare drug plan, or pick a different Medicare Advantage plan. CMS will assign a Medicare drug plan to members who don't enroll in a plan with prescription drug coverage.

Your Medicaid services then reach you a different way. HFS splits members into two groups, depending on whether they receive long-term services and supports (LTSS):

You receive LTSS You don't receive LTSS
How you get Medicaid You must be enrolled in a HealthChoice Illinois managed long-term services and supports plan for LTSS Medicaid fee-for-service program
Plan assignment Auto-enrolled in the managed long-term services and supports plan of the affiliated FIDE SNP Not applicable
What that managed long-term services and supports plan covers Only nursing facility services, HCBS waiver services, behavioral health, transportation and other services Medicare doesn't cover Not applicable
Other Medicaid services (for example, non-Medicare prescription drugs, home health and durable medical equipment) Fee-for-service, using your HFS Medical card Fee-for-service, using your HFS Medical card
Card for LTSS Your HealthChoice Illinois managed care plan ID card Not applicable

If you receive LTSS and want a different HealthChoice Illinois managed long-term services and supports plan than the one assigned, HFS says you get one change period before the enrollment takes effect and a 90-day change period after it takes effect. Currently, to switch, you must call the HFS Client Enrollment Broker at 1-877-912-8880. For what Illinois Medicaid pays in a nursing home or at home, see our guides to Illinois Medicaid nursing home care and Illinois HCBS waivers.

If You Lose Medicaid While You're in a FIDE SNP

An Illinois FIDE SNP depends on your full Medicaid coverage, so a lapse in Medicaid puts the plan at risk. The rule that bridges a short lapse is called the deeming period. HFS's D-SNP model contract requires each Illinois FIDE SNP's deeming period to be at least 90 days, and requires the plan to use it to keep coverage continuous when a member temporarily loses Medicaid eligibility.

HFS's November 2025 FIDE SNP presentation gives the plan-by-plan lengths for calendar year 2026:

  • Molina Medicare Complete Care Plus: 90 days
  • The other three Illinois FIDE SNPs: 6 months

Check your plan's member handbook to confirm. During the deeming period, the FIDE SNP provides only Medicare benefits. If your Medicaid is reinstated during the deeming period, Medicaid coverage in the FIDE SNP is effective the first day of the month after reinstatement. If your Medicaid isn't reinstated before the deeming period ends, your Illinois FIDE SNP coverage ends and you must enroll for Medicare benefits through Original Medicare or a Medicare Advantage plan, with or without drug coverage.

Nationally, under 42 CFR 422.52(d), when a special needs plan finds that a member no longer meets its eligibility criteria but can reasonably be expected to meet them again within 6 months, the member is deemed to stay eligible for not less than 30 days and not more than 6 months. A person who loses special needs status gets a special enrollment period that begins the month their status changes and ends three calendar months after the effective date of the involuntary disenrollment.

To keep Illinois Medicaid active, our guide to Illinois Medicaid recertification and renewal explains the renewal process.

Why MMAI Ended, and What 2027 Looks Like

MMAI's end coincided with a national change. CMS ended the Medicare-Medicaid Financial Alignment Initiative through rulemaking it finalized in 2022, and allowed states to continue their demonstrations through the end of 2025 if they submitted tentative plans for transitioning their Medicare-Medicaid Plan (MMP) members to integrated D-SNPs. In a September 10, 2024 memo, CMS's Medicare-Medicaid Coordination Office said it was working with the seven states then running capitated demonstrations to transition their MMPs to integrated D-SNPs effective January 1, 2026.

For contract year 2027, CMS's Medicare-Medicaid Coordination Office addressed its August 11, 2026 integrated model-materials update to plans in 23 states and territories using integrated models, and Illinois is on that list. Those model materials include the member handbook, the member ID card and the provider and pharmacy directory. Plan-level details for 2027 aren't covered here; check Medicare.gov during the Open Enrollment Period, or ask a SHIP counselor.

Free Help Choosing a Plan in Illinois

Illinois's Senior Health Insurance Program (SHIP), part of the Illinois Department on Aging, gives free, confidential and objective insurance counseling to people on Medicare and their families. Call SHIP at 1-800-252-8966, or 711 for the Telecommunications Relay Service. The Department's fact sheet tells callers to ask for the nearest SHIP office and request a meeting, at no charge, with a trained SHIP counselor. More on what SHIP does is in our Illinois SHIP guide.

For Medicare itself, call 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048), where you can talk or live chat with a real person 24 hours a day, 7 days a week, except some federal holidays. For a plan-specific problem, CMS directs beneficiaries to call their plan first, using the number on their member ID card.

Frequently Asked Questions

If I want a different Illinois FIDE SNP, who do I contact, and when does it start?

Contact the Illinois FIDE SNP you want to join, not the state: HFS's FIDE SNP presentation says the FIDE SNP, not HFS, enrolls members. Under the once-a-month Integrated Care Special Enrollment Period, coverage in the new Illinois FIDE SNP starts the first of the month after that plan gets your request.

Do I lose Medicaid if I leave my FIDE SNP?

HFS describes where your Medicaid services go if you're not in a FIDE SNP. If you receive long-term services and supports, you must be in a HealthChoice Illinois managed long-term services and supports plan for those services and get your other Medicaid services through fee-for-service with your HFS Medical card. If you don't receive long-term services and supports, you get your Medicaid services through fee-for-service with your HFS Medical card.

What does a nursing home resident pay for prescriptions in an Illinois FIDE SNP?

HFS says Illinois FIDE SNP members pay $0 for prescription drugs if they receive waiver or nursing home services. For those members, the Illinois FIDE SNP's $0 drug copay matches the $0 copays MMAI plans offered.

What did Blue Cross Blue Shield MMAI members get in 2026?

Blue Cross Blue Shield did not offer a FIDE SNP for 2026, so its MMAI members weren't moved into a same-company plan. HFS's options for dual eligibles who don't choose a FIDE SNP are Original Medicare with a drug plan or a different Medicare Advantage plan, and an eligible member can enroll in a FIDE SNP in any month.

Learn More

MedicareFully Integrated Dual Eligible Special Needs Plans (FIDE-SNPs) ExplainedFIDE-SNPs are the high-integration dual-eligible plans replacing the MMP demonstration on 1/1/2026: definitions, state landscape, and family pitfalls. MedicareMedicare and Medicaid Together: Dual Eligibility ExplainedWhat dual eligible means: how Medicare and Medicaid coordinate, full vs. partial duals, QMB cost protection, automatic Extra Help, and integrated D-SNP plans. MedicareMedicare Plans and Coverage in IllinoisMedicare in Illinois for 2026: Parts A and B, Medicare Advantage, Part D, the Illinois Medigap birthday rule, plus state help paying your costs through SHIP. MedicareIllinois SHIP: Free Medicare Counseling, What It Covers and How to Get HelpThe Illinois Senior Health Insurance Program (SHIP) offers free Medicare counseling. See what counselors help with, how to book a meeting and find a local site. MedicaidIllinois Medicaid Recertification and RenewalIllinois Medicaid renewal explained: annual redetermination, ex parte auto-renewal, the ABE portal, the 90-day reconsideration window, and how to keep coverage. MedicaidIllinois Medicaid: A Guide for Seniors and FamiliesIllinois Medicaid covers seniors and families through HFS. Learn about AABD eligibility, spend-down, long-term care, MSPs, and how to apply in 2026.

Find personalized help choosing or switching an Illinois FIDE SNP 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.

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