Demonstration States
This state’s demonstration builds on the STAR+PLUS Medicaid managed care program, which provides Medicaid-covered services—primarily LTSS—to dually eligible individuals.
What is Texas?
This “gem” of a state launched its directly capitated D-SNP program in 2014 before it had Medicaid managed care for dually eligible individuals.
What is Idaho?
This state requires each of its Medicare Advantage organizations to offer at least three separate D-SNP PBPs – one for FBDE individuals who qualify for the Pathways Medicaid managed care program, one for FBDE individuals who do not qualify for that program, and one for partial-benefit dually eligible individuals.
What is Indiana?
This state’s Medicaid carve outs make it the only state that has AIP CO D-SNPs.
What is California?
In 2027, AIP D-SNPs will have to integrate these two things.
What are ID cards and health risk assessments?
This demonstration state named it’s Medicaid managed care program based on enrollees who “Opt Out” of the FAI demo.
What is Ohio?
This state’s FIDE SNPs operate with EAE, but its aligned Quest Integration MCOs enroll non-dually eligible groups as well.
What is Hawaii?
This state uses separate contracts for its SCO and OneCare programs.
What is Massachusetts?
This territory’s directly capitated D-SNPs are HIDE SNPs because they don’t cover Medicare cost sharing. (This is a result of Medicare cost sharing not being a Medicaid-covered benefit in the territory.)
What is Puerto Rico?
With the new integrated care special enrollment period, FBDE individuals can enroll in FIDE SNPs, HIDE SNPs, or AIPs that align with an MCO with this frequency.
What is monthly?
This state designed a separate demonstration specifically for dually eligible individuals with intellectual and developmental disabilities.
What is New York?
This state launched its Pathways for Aging Program in the middle of 2024, so its aligned D-SNPs could not become HIDE SNPs until 2025. Those HIDE SNPs will become FIDE SNPs in 2026 when they begin operating with exclusively aligned enrollment.
What is Indiana?
These two states have two separate D-SNP programs to serve dually eligible individuals of different age groups.
What are Massachusetts and Minnesota?
This state’s HIDE SNPs are aligned with its AHCCCS MCOs (which serve people without a LTC need), and its FIDE SNPs are aligned with ALTCS MCOs (which serve people with LTC needs).
What is Arizona?
D-SNPs with affiliated MCOs in the same service area must operate with EAE starting in this year.
What is 2030?
This demonstration state will phase out CO D-SNPs in its demonstration counties in 2026, before it freezes enrollment in CO D-SNPs statewide in 2027.
What is Michigan?
This state directly capitates its FIDE SNPs, but it only contracts with Family Care MCOs owned by the same parent companies as the FIDE SNPs.
What is New Jersey?
This state uses separate D-SNP PBPs for its MAP and IB Duals programs.
What is New York?
This state has one plan that is a HIDE SNP, rather than a FIDE SNP, because the D-SNP’s affiliated Quest Integration MCO is operated by a different legal entity than the D-SNP.
What is Hawaii?
The CY2026 final rule requires D-SNPs to conduct HRAs within this number of days before or after the effective date of enrollment.
What is 90 days?
This demonstration state only has one MMP, which will become a FIDE SNP in 2026.
What is Rhode Island?
This state aligns its D-SNPs with its Turquoise Care MCOs, which also enroll most other Medicaid beneficiaries in the state.
What is New Mexico?
This coastal state, which now employs a former MMCO staff member, uses separate D-SNP PBPs to serve different counties in the state.
What is California?
This demonstration state will have directly capitated HIDE SNPs in 2026 because its existing Medicaid managed care program has substantial BH and LTSS carve outs.
What is Michigan?
The CY2025 final rule grants exceptions to the requirement that D-SNPs with affiliated MCOs only offer one plan in a service area if the state requires separate PBPs, or for this other reason.
What is operating both a PPO and an HMO?