10/01/2026
Beginning January 1, 2027, CMS is implementing new Medicare-Medicaid alignment requirements that will increase coordination between programs for individuals eligible for both Medicare and Medicaid.
Starting in January:
- Applicable non-EAE (Exclusively Aligned Enrollment) D-SNPs may only accept new enrollment from people enrolled in, or in the process of enrolling in, the affiliated Medicaid MCO.
- This applies where the D-SNP and affiliated Medicaid MCO operate in the same or overlapping service area.
- Existing unaligned members may remain enrolled through 2030.
Wellcare is well-positioned to support you through these changes. Through our longstanding focus on serving dual-eligible populations and helping connect members to the care and services they need, we understand the importance of coordinated, whole-person care.
Start Exploring the Resources Available to You
While implementation will occur over a few years, you can begin familiarizing yourself with the evolving alignment landscape and the different integrated plan models you may encounter.
To help you prepare, we have developed a collection of educational resources that explain alignment requirements, integrated plan models, and considerations across various care settings.
- Understanding Medicare-Medicaid Alignment and Integrated Plans for Medical Providers (PDF)
- Understanding Medicare-Medicaid Alignment and Integrated Plans for LTSS Providers (PDF)
- Understanding Medicare-Medicaid Alignment and Integrated Plans for Value-Based Care Providers (PDF)
- Home Care Agency Caregiver Guide to Medicare-Medicaid Alignment (PDF)
