Dual Eligible Project (MMP)

The Texas Health and Human Services Commission is offering a new way to serve people who are eligible for both Medicare and Medicaid, known as dual eligibles. The goal of the project is to better coordinate the care those dual eligible members receive.

The project, also known as "the demonstration," tests an innovative payment and service delivery model to improve coordination of services for dual eligibles, enhance quality of care, and reduce costs for both the state and the federal government. By having one Medicare-Medicaid health plan, Medicare and Medicaid benefits work together to better meet the member’s health-care needs.

Beginning April 1, 2015, dual eligible members in the six demonstration counties were passively enrolled into a Medicare-Medicaid plan, following a notification process, explained below. The notification process involves letters sent to members to explain the project and identify the Medicare-Medicaid plan the member was enrolled in if the member takes no action. The Medicare-Medicaid plan provides the member the full array of Medicaid and Medicare services, integrating acute care and long term services and supports.


  1. Make it easier for clients to get care.
  2. Promote independence in the community.
  3. Eliminate cost shifting between Medicare and Medicaid.
  4. Achieve cost savings for the state and federal government through improvements in care and coordination.

Geographic Area

The demonstration project covers six counties:

County Number of Enrolled Clients Health Plans
Bexar 6,552 Amerigroup, Molina, Superior
Dallas 6,668 Molina, Superior
El Paso 4,389 Amerigroup, Molina
Harris 10,909 Amerigroup, Molina, UnitedHealthcare
Hidalgo 8,047 Cigna-HealthSpring, Molina, Superior
Tarrant 4,081 Amerigroup

February 2020 figures above are estimated based on incomplete data and are subject to change as data is finalized.

Eligibilty and Enrollment

Clients may participate in the project if they meet all criteria listed below:

  • Age 21 or older.
  • Get Medicare Part A, B and D, and are receiving full Medicaid benefits.
  • Be enrolled in the Medicaid STAR+PLUS program for at least 30 days, which serves members who have disabilities and those who meet a nursing facility-level of care and get STAR+PLUS home and community-based waiver services.

The project does not include clients who reside in Intermediate Care Facilities for Individuals with Intellectual Disabilities and Related Conditions and individuals with developmental disabilities who get services through one of these waivers:

  • Community Living Assistance and Support Services
  • Deaf Blind with Multiple Disabilities Program
  • Home and Community-based Services
  • Texas Home Living Program

Members eligible to participate in the project receive a packet with their plan selection and other information before the start date. They may choose to opt-out of the project.

Other dual eligibles may opt to enroll in the project including:

  • Individuals in a Medicare Advantage plan not operated by the same parent organization that operates a STAR+PLUS MMP and who meet the eligibility criteria for the demonstration may enroll if they disenroll from their Advantage plan.
  • Individuals in the Program of All-Inclusive Care for the Elderly who meet the eligibility criteria may enroll if they disenroll from PACE and enrolled in the Medicaid STAR+PLUS program for at least 30 days.
  • Eligible individuals participating in the Centers for Medicare & Medicaid Services (CMS) Independence at Home demonstration may switch to this demonstration project.

Medicare-Medicaid Plans

Medicare-Medicaid Plan Dual Demonstration Comparison Charts

Area Chart Medicaid - Medicare Plan
Bexar English Spanish
Dallas English Spanish
El Paso English Spanish
Harris English Spanish
Hidalgo English Spanish
Tarrant English Spanish

Benefit Model

In the demonstration, the health plans must provide the full array of Medicaid and Medicare services. This includes any benefits that were added to the STAR+PLUS service array on March 1, 2015, such as nursing facility services, psychosocial mental health rehabilitation and targeted case management.

Visit the CMS website for more information about the project, including the Texas proposal and memorandum of understanding.

To see how CMS monitors and evaluates the Texas demonstration project, read Measurement, Monitoring, and Evaluation of State Demonstrations to Integrate Care for Dual Eligible Individuals (PDF).

Provider Resources