Whether you can get one plan that handles both your Medicare and your Medicaid depends on your state, and in Texas it depends on your county too. Integrated Medicare-Medicaid plans by state look very different: Illinois offers its fully integrated plans in every county, while Texas offers its Integrated D-SNPs in just five. And most people in a "dual plan" aren't in the integrated kind at all. In 2024, 46% of dual eligibles were in a dual eligible special needs plan, but only 3% of all dual eligibles were in the most integrated type, according to the Medicare Payment Advisory Commission.

In This Guide

The Three Kinds of Dual Plan

Most plans in this guide are D-SNPs: Medicare Advantage plans built for people who have both Medicare and Medicaid. What separates them is how tightly the plan is tied to your Medicaid coverage. MedPAC sorts them into three levels:

For a family, the label that matters most is one you won't see in ads: whether the plan is an "applicable integrated plan." FIDE SNPs, and HIDE SNPs whose members all get Medicaid from the same company, qualify, and an applicable integrated plan runs one combined grievance and appeal process for Medicare and Medicaid instead of two separate tracks. Our guide to fully integrated dual eligible SNPs walks through the full federal definition; this page sticks to the question of where you can actually get one.

How Integrated Medicare-Medicaid Plans Differ by State

States don't just differ in which plans they have. They differ in who can join, whether your Medicare plan has to match your Medicaid plan, and whether the integrated option covers the whole state. The tables below cover every state where Brevy has a verified, state-specific answer, using each state's own description and, where it adds something, how the Centers for Medicare & Medicaid Services (CMS) classifies its D-SNPs in its contract year 2026 integration file.

State What families call it Who can join How it's integrated
Texas Integrated D-SNPs (replaced the MMPs) Full dual-eligible adults in Bexar, Dallas, El Paso, Harris and Hidalgo counties only Choosing an Integrated D-SNP automatically enrolls you in its related STAR+PLUS Medicaid plan, with one ID card and one handbook
Illinois FIDE SNPs (replaced the Medicare-Medicaid Alignment Initiative, or MMAI) Available in every county The FIDE SNP is Illinois's only D-SNP model; four plans in 2026,
Indiana PathWays Dual Care Hoosiers 60 and older with Medicare and full Medicaid; voluntary FIDE SNPs from Anthem, Humana and UnitedHealthcare
South Carolina Healthy Connections HIDE D-SNPs Medicaid members, who must be in Medicaid managed care when they first enroll HIDE plans require exclusively aligned enrollment; CMS lists no South Carolina FIDE SNPs
Virginia D-SNPs aligned with Medicaid managed care Virginia Medicaid members who choose a D-SNP You must also join the same company's Medicaid plan; full-benefit D-SNPs must be FIDE SNPs unless the state grants an exception
Idaho Medicare Medicaid Coordinated Plan (MMCP) Duals over 21 with Medicare Parts A, B and D and Medicaid enhanced plan benefits; voluntary One plan, no cost to the member; CMS lists Idaho among FIDE states, not HIDE
New Jersey FIDE SNPs Dual eligibles One plan, one ID card, one provider network; CMS lists New Jersey among both FIDE and HIDE states
Minnesota Minnesota Senior Health Options (MSHO) People 65 and older with Medical Assistance and Medicare Parts A and B; voluntary Medicare and Medical Assistance in one plan with a care coordinator
Wisconsin Family Care Partnership D-SNPs Full-benefit duals enrolled in Family Care Partnership with that plan's organization The state's only FIDE SNPs; every member is in the same plan for Medicare and Medicaid

Four of those rows need more than a table cell:

  • Indiana draws an age line. Full-benefit duals under 60, and people with only partial Medicaid, can only pick coordination-only D-SNPs. The three PathWays Dual Care companies also run Indiana PathWays for Aging.
  • Idaho keeps some services outside the plan. Developmental disability services, non-emergency medical transportation and dental stay with the state's Medicaid program outside the plan, run by the Idaho Department of Health and Welfare, and Medicaid pays the member's Medicare premiums.
  • Wisconsin's plan is for people who need a nursing home level of care. Family Care Partnership itself requires a frail elder, physical disability or developmental disability target group, full-benefit Medicaid, a nursing home level of care and age 18 or older.
  • Minnesota lets you leave any time. An MSHO member who drops the program keeps Medical Assistance and Medicare, moves to the same plan's Minnesota Senior Care Plus coverage (or, with a medical spenddown, to fee-for-service Medical Assistance) and then has to pick a Part D plan.

Other States With a Verified Answer

State What families call it How CMS classifies its D-SNPs What to know
District of Columbia District Dual Choice Highly integrated and coordination-only; no FIDE SNPs Optional, open to partial or full duals; leaving changes both your Medicare and your Medicaid
Delaware D-SNPs listed by the state's Division of Medicaid and Medical Assistance Highly integrated and coordination-only; no FIDE SNPs Three plans: AmeriHealth VIP Care, Delaware First Health (Wellcare) and Highmark Health Options Duals
Washington Apple Health Medicare Connect Highly integrated and coordination-only; none is an applicable integrated plan Open to all dual-eligible clients, including people whose Medicaid covers only Medicare cost-sharing
Oregon D-SNPs that work with your Oregon Health Plan coordinated care organization Highly integrated and coordination-only; none is an applicable integrated plan The state says D-SNPs work closely with Oregon Health Plan benefits and are available in many areas; ask your coordinated care organization which Medicare Advantage plans work with it
Kansas D-SNPs run by Kansas Medicaid plans Highly integrated and coordination-only; none is an applicable integrated plan A Kansas Medicaid update prepared for an October 2024 legislative committee said duals were not required to pick the same company for both
Nebraska Heritage Health plan HIDE D-SNPs Highly integrated and coordination-only; none is an applicable integrated plan The 2022 Heritage Health contract procurement required its plans to have a HIDE D-SNP to serve dual eligibles under one plan
Iowa D-SNPs listed by the Iowa Insurance Division (no state program name) Five highly integrated and five coordination-only plans; none is an applicable integrated plan Iowa is the one state here where you can see which plan is which (below)

States Covered in Brevy's Medicaid Guides

Seven states run dual-eligible programs closely tied to their Medicaid managed care, so their guides live in our Medicaid section:

State Program What it is
California Medi-Medi Plans Exclusively aligned D-SNPs for people 21 and older with Medicare Parts A and B and Medi-Cal
Massachusetts One Care and Senior Care Options One Care moved onto a D-SNP platform for 2026 and serves adults with disabilities ages 21 to 64 at enrollment
New York Medicaid Advantage Plus One organization for Medicare, Medicaid, long-term care and drug benefits, for people 18 and older
Tennessee BlueCare Plus and other D-SNPs TennCare's 2026 table lists 13 D-SNPs from six companies
Ohio Next Generation MyCare FIDE SNPs for people 21 and older with full Medicaid and Medicare Parts A, B and D
Pennsylvania Community HealthChoices Medicaid side only: the state's mandatory Medicaid managed care program for dual eligibles 21 and older, through three plans
Michigan MI Coordinated Health A HIDE SNP that replaced MI Health Link on January 1, 2026, for residents 21 and older

Six More Places Using CMS's Integrated Plan Models

For 2027, CMS sent its integrated member materials update to applicable integrated plans in 23 states and territories, including Arizona, Florida, Hawaii, New Mexico, Rhode Island and Puerto Rico. Brevy doesn't yet have a verified state-level breakdown for those six, so check the plans in your county before you assume what's offered.

Three States With No D-SNPs

In 2026, D-SNPs are offered in 47 states and DC; Alaska, New Hampshire and Vermont have none. If you live in one of the remaining states not named on this page, D-SNPs exist, but we haven't verified which integration levels are offered, so ask before you assume a plan is integrated.

Find Your State's Integrated Dual Plan Guide

Pick your state for its plans, who qualifies and how to enroll:

CaliforniaView guide IdahoView guide IllinoisView guide IndianaView guide MassachusettsView guide MichiganView guide MinnesotaView guide New JerseyView guide New YorkView guide OhioView guide PennsylvaniaView guide South CarolinaView guide TennesseeView guide TexasView guide VirginiaView guide WisconsinView guide
16 states

When "Highly Integrated" Still Means Two Systems

In Washington, Oregon, Kansas, Nebraska and Iowa, CMS's 2026 file lists highly integrated and coordination-only D-SNPs, no FIDE SNPs, and marks every highly integrated plan as not an applicable integrated plan.

That matters because the single combined appeal process is a feature of applicable integrated plans. So in these five states, don't count on one appeal track for both programs just because a plan says "highly integrated." Ask the plan how a Medicaid denial gets appealed before you switch.

What CMS's label does not mean is that you're locked out of switching. The monthly integrated care special enrollment period covers HIDE SNPs, not only fully integrated plans, so a full-benefit dual eligible in these states can use it, as long as the move lines up the D-SNP with the company running their Medicaid managed care plan. A few state-specific wrinkles:

  • Washington opens its D-SNPs to dual eligibles whose Medicaid covers only Medicare cost-sharing, and your behavioral health care stays with your Apple Health Behavioral Health Services Only plan, which can be the same company or a different one. The monthly integrated care switch, though, is for full-benefit duals only.
  • Kansas: a Kansas Medicaid managed care update prepared for an October 22, 2024 legislative committee meeting said dual eligibles weren't required to enroll in the same D-SNP company as their Medicaid plan. That statement describes 2024; the 2027 rules below may change things for new enrollees whose D-SNP company also runs a Kansas Medicaid plan.
  • Iowa is the one state in this group where the plans can be told apart by contract-plan ID. In 2026, Iowa's five highly integrated D-SNP packages are Wellpoint Full Dual Advantage (H0907-001) and Full Dual Advantage 2 (H0907-003), Molina Medicare Complete Care (H1799-004 and H1799-005) and Wellcare Dual Liberty Sync (H1862-003). Since a coordination-only D-SNP can't be reached through the monthly integrated care switch, those five are the only Iowa plans it applies to.

How to Switch Into an Integrated Plan

You don't have to wait for fall open enrollment. Since January 1, 2025, a full-benefit dual eligible (the QMB+, SLMB+ and full-benefit categories) can make a once-a-month election into a FIDE SNP, a HIDE SNP or an applicable integrated plan, with the new coverage starting the first day of the next month.

The condition is alignment. You have to be using the switch to line up your D-SNP with the same company's Medicaid managed care plan. If you're staying in Medicaid fee-for-service or in a different company's Medicaid plan, the monthly integrated care special enrollment period isn't available to you. But being in fee-for-service today doesn't shut you out: if you're eligible for and want to join that company's Medicaid plan, you can use it.

Who it doesn't cover:

Medicare.gov describes the right itself as joining an integrated D-SNP "if one’s available in my area," so start by finding out what serves your county. Your state guide above is the fastest route. You can also call 1-800-MEDICARE (1-800-633-4227), the official Medicare line, open 24 hours a day, 7 days a week except some federal holidays; TTY users call 1-877-486-2048.

What Changes in 2027 and 2030

You may have heard that "your Medicare and Medicaid plans must match in 2027." That's true for some people, not everyone. Here's how CMS's April 2026 guidance on the rule describes it:

  • 2027: if your D-SNP's company, or its parent or a sister company, also runs a Medicaid managed care plan for full-benefit dual eligibles in your area, the D-SNP can only take new members who are in, or joining, that Medicaid plan.
  • 2030: a D-SNP whose company, or its parent or a sister company, runs a Medicaid managed care plan for full-benefit dual eligibles in your area may only cover members of that affiliated Medicaid plan, and members who aren't aligned get disenrolled.
  • Not affected: a D-SNP whose company runs no Medicaid managed care plan for full-benefit duals in the state.
  • If you're already enrolled and not aligned, you can stay until 2030.
  • A fee-for-service exception: where the state doesn't require all full-benefit duals to be in Medicaid managed care, and the state's contract allows it, a company may enroll people in Medicaid fee-for-service in a coordination-only or HIDE D-SNP, and that exception continues past 2030.

Some companies will respond by folding several D-SNPs in your area into one. For 2027 and later, CMS lets a company family that consolidates down to a single D-SNP move members into the surviving plan, called a crosswalk, but only into a plan the member is eligible for and never between plan types, so an HMO D-SNP member can't be moved into a PPO D-SNP. Where state policy requires the surviving plan to be exclusively aligned, members who aren't in the matching Medicaid plan can't be crosswalked into it.

Applicable integrated plans also have to give you one integrated Medicare-Medicaid member ID card and a single integrated health risk assessment no later than 2027.

States are changing on their own timelines too. In Texas, on January 1, 2027, the parent companies of the remaining STAR+PLUS plans in Bexar, Dallas, El Paso, Harris and Hidalgo counties are scheduled to start running Integrated D-SNPs; it's a second phase inside those counties, not an expansion beyond them.

If Your Plan Changed on January 1, 2026

If you were in a Medicare-Medicaid Plan (MMP) and woke up in January with a different plan name, you weren't imagining it. CMS ended the demonstration those plans ran under, let states keep them through the end of 2025, and worked with the seven states still running them to move members into integrated D-SNPs effective January 1, 2026. Where the MMP's company offered a D-SNP, CMS let it move its members over; MMPs with no successor plan were to end with 2025.

Two examples from the states:

  • Illinois: members of an MMAI plan run by Aetna, Humana, Meridian or Molina were automatically enrolled by CMS in the same company's FIDE SNP, starting January 1, 2026, unless they chose other coverage. Blue Cross Blue Shield didn't offer a FIDE SNP for 2026.
  • Texas: MMP members who didn't want to be auto-enrolled into an Integrated D-SNP had to choose another D-SNP by November 30, 2025, and their services were to continue at the same level for up to six months, or until the new plan finished its assessments and issued new authorizations, whichever came first.

Michigan and Massachusetts went through the same change; see their Medicaid guides in the table above., If the plan you were moved into doesn't suit you, the monthly switches described above still apply.

If You Lose Medicaid While in a Dual Plan

Losing Medicaid, even over a paperwork gap, doesn't have to mean losing your D-SNP that month, but the grace period isn't a fixed guarantee. Federal rules let a special needs plan keep treating you as eligible for 30 days to 6 months, if it expects you to qualify again within 6 months, and CMS lets each plan pick its own length from one to six months.

The deemed-eligibility period starts the first of the month after the plan learns of the loss and tells you. If you don't requalify in time, the plan should send a disenrollment notice at least 30 days ahead, and you get a special enrollment period that runs until three months after the disenrollment takes effect. Ask your plan for its policy now, before a paperwork gap turns into a coverage gap.

Frequently Asked Questions

Is there an integrated Medicare and Medicaid plan in my state?

If you live anywhere except Alaska, New Hampshire or Vermont, your state has D-SNPs in 2026, but a D-SNP isn't automatically an integrated plan. To check a specific plan, CMS posts the current year's list of integrated D-SNPs on its D-SNP integration page, and its annual Medicare Advantage landscape file records each plan's FIDE, HIDE or applicable integrated plan status alongside its service area.

Do I have to join an integrated plan?

Not in Indiana, Idaho, Minnesota, DC or Texas, the places where Brevy has verified the rule. Indiana's PathWays Dual Care, Idaho's MMCP, Minnesota's MSHO and DC's District Dual Choice are all described by their states as voluntary or optional, and Texas's Integrated D-SNPs are an additional option alongside Original Medicare and other plans.,, Wisconsin is the exception: dually eligible Family Care Partnership members are required to enroll in their managed care organization's D-SNP. Some states require managed care on the Medicaid side only. Pennsylvania's Community HealthChoices is mandatory Medicaid managed care for dual eligibles, and in the counties Idaho Medicaid lists, duals who aren't in the MMCP must join Idaho Medicaid Plus, which covers Medicaid benefits only and doesn't change their Medicare coverage.,

Can I join if I only have partial Medicaid?

It depends on the state. DC's District Dual Choice is open to partial or full duals, and Washington's D-SNPs take people whose Medicaid covers only Medicare cost-sharing. In Indiana, partial duals can only choose coordination-only D-SNPs. Either way, the monthly integrated care special enrollment period is for full-benefit duals only.

Will I lose my D-SNP in 2027 if my Medicaid plan is a different company?

The enrollment limits alone won't remove you in 2027. CMS's 2027 D-SNP aligned-enrollment limits stop an affected D-SNP from taking new unaligned members, and existing unaligned members can stay until 2030, when the plan must disenroll anyone not also in its affiliated Medicaid plan. A D-SNP whose company runs no Medicaid managed care plan for full-benefit duals in your state isn't affected at all. The risk in 2027 is consolidation. To comply with CMS's 2027 aligned-enrollment rule, a company family may fold its D-SNPs in your area into one and crosswalk members into the surviving plan, but only members who are eligible for it. Where the state requires that surviving plan to be exclusively aligned, members who aren't in the company's matching Medicaid plan can't be moved into it. If your plan's company is consolidating, ask whether you're eligible for the plan that survives.

Can I leave an integrated plan if it doesn't suit me?

Yes. Full-benefit and partial dual eligibles can use the monthly Dual/LIS special enrollment period to move to Original Medicare with a standalone drug plan, with the change starting the first day of the next month; the exception is someone identified as a potential at-risk or at-risk beneficiary under a Part D drug management program. Leaving can change your Medicaid too. In DC, you can't keep District Dual Choice for Medicare while leaving it for Medicaid, and your Medicaid becomes fee-for-service. Ask the plan how your Medicaid will be delivered before you leave.

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 Special Needs Plans (SNPs) ExplainedMedicare Special Needs Plans restrict enrollment to specific groups. Learn the three types, C-SNP, D-SNP, and I-SNP, who qualifies, and how to enroll in 2026. MedicareDual Eligible: Medicare and Medicaid TogetherWhat dual eligible means: how Medicare and Medicaid coordinate, full vs. partial duals, QMB cost protection, automatic Extra Help, and integrated D-SNP plans. MedicareMedicare Special Enrollment Periods: Which One Is YoursThe life events that let you enroll in or switch Medicare outside the usual windows: retiring past 65, losing Medicaid, moving, a plan exit, and the COBRA trap. MedicareMedicare vs. Medicaid: What's the Difference and Can You Have Both?Medicare vs. Medicaid: Medicare is federal insurance for people 65+; Medicaid is state-run help for limited incomes. See costs, nursing homes and having both.

Find personalized help finding the integrated Medicare-Medicaid plan options in your state 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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