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Illinois Medicaid - HFSMedicare Advantage · Administrative · Provider Notice · ILHigh impact

Important Updates on the Medicare Medicaid Alignment Initiative (MMAI) transition to Dual Eligible Special Needs Plan (D-SNP)

Act
by Jan 1, 2026
Effective date
Jan 1, 2026
Identified
Jun 20, 2026

Summary

Illinois is transitioning from MMAI to FIDE SNP plans effective January 1, 2026, requiring new member verification processes. Billing teams must verify patient enrollment using new contract numbers and health plan portals since state systems are still being updated.

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What to do

by Jan 1, 2026 · 4 steps
01Billing and front desk staff must implement new patient verification process for dual-eligible members.
02Request member ID cards at service time and verify enrollment using health plan portals or contract numbers: Aetna (H9771001), Humana (H4329001), Molina (H3093001-H3093005 by region), Wellcare Meridian (H6971001).
03Use MEDI portal with these contract numbers until systems are fully updated.
04Extended call center hours available through March 31, 2026 for verification assistance.

Original notice

Important Updates on the Medicare Medicaid Alignment Initiative (MMAI) transition to Dual Eligible Special Needs Plan (D-SNP)
hfs.illinois.gov · Always check the source before changing claims.
View original ↗

Related changes

See all Illinois Medicaid - HFS changes →
Medicare Medicaid Alignment Initiative (MMAI) transition to Dual Eligible Special Needs Plan (D-SNP)HighEffective Jan 1, 2026 · Provider NoticeUpdate: Medicare Medicaid Alignment Initiative (MMAI) transition to Dual Eligible Special Needs Plan (D-SNP)MediumNo effective date · Provider NoticeImportant Updates on the Medicare Medicaid Alignment Initiative (MMAI) transition to Dual Eligible Special Needs Plan (D-SNP)HighEffective Jan 9, 2026 · Provider NoticeImportant Updates on the Medicare Medicaid Alignment Initiative (MMAI) transition to Dual Eligible Special Needs Plan (D-SNP)MediumEffective Jan 20, 2026 · Provider NoticeBrowse every Illinois Medicaid - HFS change in the policy list

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