What is a Medicare Advantage Medicare-Medicaid plan (MMP)?

A Medicare Advantage Medicare-Medicaid plan (MMP) is a private health plan designed to provide integrated and coordinated Medicare and Medicaid benefits for dual eligible Medicare beneficiaries.

Unlike a Medicare Advantage Dual Eligible Special Needs Plan (D-SNP), MMPs only serve full benefit dual eligible (Medicare/Medicaid) beneficiaries and some additional limitations may apply (such as state-specific requirements).

As noted by the Centers for Medicare and Medicaid Services (CMS):

"A Medicare-Medicaid Plan (MMP) [like a D-SNP] is a private health plan that has been competitively selected and approved to provide integrated care to eligible full-benefit Medicare-Medicaid enrollees under the CMS Financial Alignment Demonstration."

CMS also notes that MMPs are only allowed to operate in select counties within states that have completed a three-step CMS approval process culminating in a three-way contract between CMS, the state, and the MMP provider.

Medicare-Medicaid plans were introduced in 2014 and are only offered in a few counties across the country.

• In 2025, only 27 MMPs are offered across the country as compared to 3,235 local HMO Medicare Advantage plans.
• In 2024, only 28 MMPs were offered across the country as compared to 3,311 local HMO Medicare Advantage plans.
• In 2021 and 2022, only 43 MMPs were offered across the country as compared to 3,277 local HMO Medicare Advantage plans.
• In 2020, there were only 44 MMPs offered across the country as compared to 2,777 local HMOs.

References:

CMS, “Financial Alignment Initiative,” (www.cms.gov/ Medicare-Medicaid-Coordination/ Medicare-and-Medicaid-Coordination/ Medicare-Medicaid-Coordination-Office/ FinancialModelstoSupportStates EffortsinCareCoordination.html.)