Molina Healthcare has secured a significant contract from the Illinois Department of Healthcare and Family Services to provide a Fully Integrated Dual Eligible Special Needs Plan (D-SNP). This program will replace the existing Medicare-Medicaid Alignment Initiative (MMAI), serving approximately 73,000 dual-eligible beneficiaries—those qualifying for both Medicare and Medicaid. The contract is set to begin on January 1, 2026, with an initial four-year term and potential extensions for up to ten years. Molina is one of four managed care organizations selected to oversee care for this vulnerable population, reinforcing its position in the state’s healthcare system.
This contract reflects Illinois’ broader efforts to enhance care coordination and streamline services for dual-eligible individuals by shifting from the MMAI demonstration program to a more integrated D-SNP model. By managing both Medicare and Medicaid benefits under one plan, Molina aims to improve patient outcomes while reducing healthcare costs through better care coordination. The agreement also strengthens Molina’s footprint in government-sponsored healthcare, aligning with its long-term strategy to expand managed care services across multiple states.
The benefits of being dual-eligible include assistance with Medicare premiums, deductibles, and copayments, thereby reducing out-of-pocket expenses. Additionally, Medicaid may offer services beyond Medicare’s scope, such as long-term care and personal care assistance. To apply for dual eligibility, individuals must meet the specific criteria for both programs, which can vary by state. Applications are typically submitted through the respective state Medicaid agency, and eligibility is determined based on the state’s guidelines.
