Texas • Medicare and Medicaid
Texas STAR+PLUS integrated D-SNP expansion: January 1, 2027
Phase II adds integrated Medicare and Medicaid plan options in Bexar, Dallas, El Paso, Harris and Hidalgo counties on January 1, 2027. It is not a statewide requirement for everyone with Medicare to change plans.
What is changing on January 1?
Reviewed November 8, 2026. An integrated Dual Eligible Special Needs Plan, or integrated D-SNP, coordinates Medicare with a related STAR+PLUS Medicaid plan. Texas began this model in five counties on January 1, 2026. Phase II requires the remaining STAR+PLUS managed care organizations in those same counties to operate integrated D-SNPs beginning January 1, 2027.
The October 19, 2026 HHSC announcement identifies these county and health-plan combinations:
| County | Already operating in 2026 | Added January 1, 2027 |
|---|---|---|
| Bexar | Molina Healthcare of Texas | Community First Health Plan; United Healthcare Texas |
| Dallas | Molina Healthcare of Texas; Superior Health Plan | United Healthcare Texas |
| El Paso | Molina Healthcare of Texas | El Paso Health |
| Harris | Molina Healthcare of Texas; United Healthcare Texas | Community Health Choice |
| Hidalgo | Molina Healthcare of Texas; Superior Health Plan | United Healthcare Texas |
These are the organizations listed by HHSC. Confirm the exact Medicare plan name and contract/plan number in your 2027 enrollment materials. A company’s presence elsewhere in Texas does not extend this five-county announcement to another county.
Who should review these options?
HHSC describes integrated D-SNPs as an additional option for adults with Medicare and full Medicaid benefits in the five counties. Having help with Medicare premiums alone does not establish full Medicaid eligibility. Confirm your Medicaid category and STAR+PLUS eligibility before choosing a plan.
HHSC’s member guidance says choosing an integrated D-SNP for Medicare automatically aligns enrollment with that plan’s related STAR+PLUS Medicaid plan. The model includes one member card, combined member materials and coordinated appeals and complaints.
That Medicaid alignment is different from automatically moving every person with Medicare into a D-SNP. HHSC continues to describe Original Medicare, Medicare Advantage and D-SNP choices for people with both programs. Read your individual letter to learn whether your current plan is changing and whether you must make an election.
Confirm the choice and its effective date
Medicare’s Annual Enrollment Period is October 15–December 7, 2026 for changes starting January 1, 2027. People with Medicare and full Medicaid may also qualify for a monthly Special Enrollment Period to join an available integrated D-SNP that aligns with their Medicaid managed care plan. Medicare says qualifying changes take effect on the first day of the following month. See its enrollment guide.
Do not assume you can switch to any Medicare Advantage plan every month. Ask the plan or Medicare which enrollment period applies to the exact coverage you want. Confirm the Medicare and Medicaid effective dates together.
For help reviewing the Medicare side, request a Thompson Medicare Brokerage callback or call (855) 982-6525. Have both insurance cards and your 2027 notice ready. A callback request is not a confirmed appointment. Your STAR+PLUS service coordinator can help with your Medicaid services.
Protect ongoing care during a plan change
Before enrollment, check your Medicare doctors, hospital, prescriptions and pharmacy. Also check the Medicaid providers you rely on, including personal assistance, home services, nursing facility care, transportation and equipment. A doctor-network check alone does not answer whether your long-term services are arranged.
Ask the incoming plan and service coordinator to review your current service plan, authorizations, provider contacts and scheduled care. Get the transition arrangements in writing. CMS continuity-of-care rules require a minimum 90-day period without new prior authorization for an active course of treatment when a person switches to a new Medicare Advantage coordinated care plan. That protection is not a blanket promise that all services, providers or Medicaid authorizations stay unchanged indefinitely.
For members changing organizations on January 1, HHSC instructs home-service providers to use current electronic visit verification authorizations through December 31, 2026, then update the payer and authorization records for 2027. These are provider tasks. Members and caregivers should tell the service coordinator about a plan change and confirm who will provide each scheduled service.
Your November and December checklist
- Confirm your county, full Medicaid status and current Medicare and STAR+PLUS plans.
- Read every 2027 letter. Identify any required action and the stated deadline.
- Compare both medical and long-term-service providers before selecting a plan.
- Ask who will coordinate your care and how existing treatment and authorizations will be handled.
- Keep enrollment confirmation, new cards and the name of the person who confirmed your January services.
If you already use an integrated plan that continues for 2027, the Phase II announcement alone does not mean you must switch. If a letter says your Medicare plan is ending, review that separate nonrenewal notice promptly. The old Medicare-Medicaid demonstration ended December 31, 2025; Phase II is the next stage of the integrated D-SNP model, not a new statewide end to Medicaid.
Questions before you decide
Frequently Asked Questions
Does Phase II apply throughout Texas?
No. The January 1, 2027 announcement names Bexar, Dallas, El Paso, Harris and Hidalgo counties. Other counties may have Medicare or D-SNP choices, but this announcement does not establish the same integrated options there.
Will my Medicaid plan change if I choose an integrated D-SNP?
It can. HHSC says enrollment is aligned with the integrated D-SNP's related STAR+PLUS plan. Verify the Medicaid organization and your service providers before completing a Medicare enrollment.
Can I keep my home-care worker or specialist?
Check with the incoming plan and service coordinator. Ask about network participation, transition protections, current authorizations and the plan for ongoing services. Do not assume either that care must stop or that every arrangement continues automatically.
Who can help with a service problem during the transition?
Start with your plan's member services and STAR+PLUS service coordinator, using the number on your card. For Medicare enrollment questions, call 1-800-MEDICARE. HHSC's STAR+PLUS page also links to its complaint process.
Primary references
Official Sources
- HHSC: Phase II organizations, counties and January 1, 2027 date
- HHSC: Options for Medicare and Medicaid dual coverage
- HHSC: STAR+PLUS eligibility, services and service coordination
- Medicare: Enrollment periods and integrated D-SNP enrollment
- CMS: Medicare Advantage continuity-of-care protections
Sources checked November 8, 2026. Confirm your exact plan, provider, location and effective date before acting. Network participation, plan terms and enrollment rules can change.
Independent Medicare guidance
Review both sides of your coverage before January 1
Call (855) 982-6525 or request a callback with your county and current plan names. Coordinate Medicaid services with your STAR+PLUS plan. Submitting a callback request does not confirm an appointment or change enrollment.
No-cost, no-obligation help is available by phone or video. I review the plans I represent in your area.
Use the callback form to request contact. Keep Medicare numbers, medication lists and medical details out of the general message; I can arrange an appropriate way to review them.
Thompson Medicare Brokerage is an independent, non-government insurance agency. This educational guide is not issued or endorsed by the hospitals, agencies or insurers discussed and does not imply a partnership. We are not connected with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in every area. Contact Medicare.gov, 1-800-MEDICARE or your State Health Insurance Assistance Program for information about all available options. Provider access, benefits, costs and enrollment eligibility depend on the exact plan and circumstances.