Texas Integrated D-SNP Plans: What Replaced Your MMP in 2026

Texas ended its Medicare-Medicaid Plans (MMPs) on December 31, 2025, and since January 1, 2026, Texas Integrated D-SNPs have taken their place in five counties.1 A Texas Integrated Dual Eligible Special Needs Plan (Integrated D-SNP) is a Medicare plan for people with full Medicaid too, run by the same company as your Medicaid health plan, with one ID card and one handbook for both.1 A Texas MMP member who did not choose a new, unaligned D-SNP by November 30, 2025 was auto-enrolled into an Integrated D-SNP.2

In This Guide

• Which Companies Offer a Texas Integrated D-SNP in Your County?
• How Does a Texas Integrated D-SNP Work?
• What Happened to Your Medicare-Medicaid Plan?
• What Are Your Options Outside the Five Counties?
• How and When Can You Change Plans?
• What Changes for Texas D-SNPs in 2027 and 2030?
• What Happens If Your Medicaid Lapses?
• Where Can You Get Free Help?
• Frequently Asked Questions
• Learn More

Which Companies Offer a Texas Integrated D-SNP in Your County?

The Texas Health and Human Services Commission (HHSC) lists three health plan companies offering Integrated D-SNPs in 2026: Molina Healthcare of Texas, Superior HealthPlan and UnitedHealthcare Community Plan of Texas.1 The choice depends on your county.

These are the companies HHSC names for 2026.1 Molina, Superior and UnitedHealthcare may not be the only Texas Integrated D-SNP companies in 2027. HHSC has scheduled a second phase for January 1, 2027, when the parent companies of the remaining STAR+PLUS plans in these five counties are to begin operating Integrated D-SNPs.5 In that second phase, the Texas Integrated D-SNP model stays limited to Bexar, Dallas, El Paso, Harris and Hidalgo counties.5

Plans and service areas are set each year, so check the list for the coming year during Medicare's annual open enrollment period, which runs October 15 through December 7.6 The Medicare Plan Finder shows the plans offered at your address, and Texas HICAP can help you compare the 2027 choices before you pick one.

How Does a Texas Integrated D-SNP Work?

A Texas Integrated D-SNP is a Dual Eligible Special Needs Plan (D-SNP) open only to full dual-eligible adults in the five counties.1 HHSC runs the Texas version as a Medicare-led exclusively aligned enrollment model: when you choose an Integrated D-SNP for your Medicare coverage, HHSC automatically enrolls you in that D-SNP's related STAR+PLUS (Medicaid) plan.1 So you are in two plans, a Medicare plan and a Medicaid plan, both from the same company.

In a Texas Integrated D-SNP, the pairing shows up in two places:

• One ID card and one handbook: Integrated D-SNP members get one ID card and one handbook for both Medicare and Medicaid.1
• One appeal notice: An Integrated D-SNP member receives one appeal rights notice for both Medicare and Medicaid that directs the member to one contact to request appeals for both programs.2

At the federal level, the Centers for Medicare & Medicaid Services (CMS) addressed its contract year 2027 integrated model materials (member handbook, ID card, and provider and pharmacy directory) to applicable integrated plan D-SNPs in 23 states and territories, Texas among them.7 CMS's list names states, not individual plans, so it does not by itself say which Texas plans are applicable integrated plans.

For who qualifies for STAR+PLUS and what it pays for, see our guide to Texas STAR+PLUS, and for comparing the Medicaid plans themselves, see how to choose a Texas Medicaid managed care plan.

What Happened to Your Medicare-Medicaid Plan?

Under the Texas Dual Demonstration, a Medicare-Medicaid Plan was one capitated plan under a three-way contract between CMS, the state Medicaid agency and the health plan.8 CMS ended the Medicare-Medicaid Financial Alignment Initiative, the federal demonstration behind MMPs, through rulemaking it finalized in 2022, and let states run their MMPs through the end of 2025 if they planned to move members into integrated D-SNPs.8 Where an MMP's company would offer an integrated D-SNP in 2026, CMS allowed that company to move its MMP members into the D-SNP.8

In Texas, HHSC ended the Dual Demonstration on December 31, 2025, and the companies that ran the MMPs began operating Integrated D-SNPs on January 1, 2026.1 HHSC's member materials set out how the change worked:

• Default enrollment: An MMP member who did not want to be auto-enrolled into an Integrated D-SNP had to choose a new, unaligned D-SNP by November 30, 2025.2 A member who made no other choice was auto-enrolled into an Integrated D-SNP, which also placed that member in the same company's STAR+PLUS plan.1
• Continuity of care: Each MMP member's health plan must keep that member's current services and care going without interruption. HHSC told its Medical Care Advisory Committee that services continue at the same level for up to six months after the transfer, or until the new plan finishes all required assessments, a service plan and new authorizations, whichever comes first.2
• Your service plan: A former MMP member's existing individual service plan (ISP) stays in place until the health plan contacts the member or the member's authorized representative to schedule an assessment.2

If a former MMP member's care seemed to change after January 1, 2026, ask the health plan which of those continuity limits applies to that member, and whether a new assessment has been scheduled. If you disagree with a decision, the single appeal notice tells you where to ask for an appeal for both Medicare and Medicaid.2 Our guide to Texas Medicaid appeals and fair hearings covers the Medicaid side in more detail.

What Are Your Options Outside the Five Counties?

Texas Integrated D-SNPs are an additional option only in the five former demonstration counties.1 In all Texas counties, a dual-eligible person enrolling in STAR+PLUS can choose one of three Medicare options:1

• Original Medicare
• A Medicare Advantage plan
• A D-SNP

Those same three options are open inside the five counties too, so an Integrated D-SNP is a choice there, not a requirement.1 For how Medicare and Medicaid split the bills when you have both, see Medicare vs. Medicaid in Texas, and for the full menu of Texas Medicare choices, see Medicare plans and coverage in Texas.

How and When Can You Change Plans?

Full dual eligibles do not have to wait for open enrollment. Under the contract year 2025 Medicare Advantage and Part D final rule, people with full Medicare and full Medicaid get a once-per-month "integrated care" special enrollment period to enroll in an aligned integrated D-SNP (a fully integrated, highly integrated or applicable integrated plan).3 The same rule gives dual eligibles and people with Extra Help a once-per-month special enrollment period to elect a stand-alone Part D prescription drug plan, except while a person is identified as a potential at-risk or at-risk beneficiary under a Part D drug management program.3 Our guide to Medicare special enrollment periods lists the others.

Because a Texas Integrated D-SNP is paired with a STAR+PLUS plan, changing one side can change the other. HHSC's member presentation explains what happens:2

HHSC says you can contact the Texas Medicaid Enrollment Broker to change your STAR+PLUS plan at any time.2 Before you switch either plan, ask whether your doctors and long-term care providers are in the new plan's network.

What Changes for Texas D-SNPs in 2027 and 2030?

Two changes reach Texas D-SNPs in 2027, one from HHSC and one from a federal rule. HHSC's second phase, described above, starts January 1, 2027 and may give members in the five counties more Integrated D-SNP companies to choose from.5 HHSC's stated next step after that phase is to analyze data on the Integrated D-SNP model to inform future integration.5

Separately, a federal rule on dual eligible special needs plans, 42 CFR 422.514(h), starts to apply in 2027. CMS's April 2026 questions and answers on that rule explain whom it reaches.9

• Starting in 2027: If a D-SNP's company, or a company under the same parent, also runs a Medicaid managed care plan for full dual eligibles in the same service area, that D-SNP may only take new enrollees who are in, or are enrolling in, that affiliated Medicaid plan.9
• Current members: A D-SNP member who is not in the affiliated Medicaid plan may stay in the D-SNP until 2030.9
• Starting in 2030: A D-SNP whose company also runs an affiliated Medicaid managed care plan for full dual eligibles in the same area may only enroll or keep members who are also in that affiliated Medicaid plan, and the company must disenroll members who are not.9
• Who is not affected: A D-SNP whose company does not run a Medicaid managed care plan serving full dual eligibles in the state is not covered by these limits.9
• Exceptions: The contract year 2027 final rule added an exception to the 42 CFR 422.514(h) enrollment limits. Where a state does not require Medicaid managed care for all full dual eligibles and the state's Medicaid contract allows it, a company that also runs an affiliated Medicaid managed care plan may enroll full dual eligibles who are in Medicaid fee-for-service in its coordination-only or highly integrated (HIDE) D-SNP, but not people enrolled in another, unaffiliated company's Medicaid managed care plan. If state policy allows, that company may also run coordination-only D-SNPs limited to partial-benefit dual eligibles in the same area.9

The federal limits apply to all types of D-SNPs, not only integrated ones.9 So in Texas, the question for any D-SNP is whether its company also runs a STAR+PLUS (Medicaid managed care) plan for full dual eligibles in your area. If it does and your STAR+PLUS plan is from a different company, the 2027 limit generally applies to any new enrollment in that D-SNP, and the 2030 limit applies if you are still unmatched then.9 A Texas Integrated D-SNP member is already matched, because choosing the Integrated D-SNP put that member in the same company's STAR+PLUS plan.1 Whether an exception fits your situation depends on Texas policy and your plan, so check with Texas HICAP before you switch D-SNPs.

What Happens If Your Medicaid Lapses?

If you lose Medicaid at a renewal, your D-SNP may find that you no longer meet its eligibility criteria. Federal rules give a cushion. Under 42 CFR 422.52(d), if a special needs plan finds that an enrollee no longer qualifies but can reasonably be expected to qualify again within six months, the enrollee is deemed to stay eligible for at least 30 days and no more than six months.10 CMS's contract year 2027 guidance says the special needs plan chooses the length of its deemed continued eligibility period, anywhere from one to six months, as long as it applies the same policy to all of its members and tells them what it is.10

• If you don't requalify in time: A special needs plan member who does not requalify within the plan's deemed continued eligibility period is expected to be disenrolled at the end of it, and the plan should send a disenrollment notice at least 30 days before disenrollment.10
• Your enrollment window: A person who loses special needs status gets a special enrollment period that starts the month the status changes and ends three calendar months after the disenrollment takes effect.10
• The 2030 rule keeps this cushion: The 2027 and 2030 aligned-enrollment limits still let affiliated D-SNPs use deemed continued eligibility.10

The easiest way to avoid this is to renew your Texas Medicaid coverage on time. Our guide to Texas Medicaid recertification and renewal walks through it.

Where Can You Get Free Help?

Texas HICAP is Texas's State Health Insurance Assistance Program, and Texas HHSC presents it as free benefits counseling from a trusted and unbiased source for people eligible for Medicare.4 HICAP counselors explain Medicare Advantage, including enrollment and disenrollment, and Part D drug plan comparisons.4 A HICAP session is a good step before you change from or to a Texas Integrated D-SNP. For more on the program, see our Texas HICAP guide.

HHSC publishes the Medicaid and Medicare contacts in its transition materials,2 and the HICAP number is the one HHSC gives for the program.4

Learn More

Find personalized help choosing between a Texas Integrated D-SNP and your other Medicare 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.