Illinois Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs)

Fully Integrated Dual Eligible Special Needs Plans (FIDE SNPs) are Medicare Advantage plans that provide both Medicare and Medicaid benefits, including long-term services and supports, through one plan. In Illinois they replaced the Medicare-Medicaid Alignment Initiative (MMAI) on January 1, 2026. It sits alongside our Illinois Long-Term Care Medicaid guide, which covers the nursing home rules.

Figures change periodically. Double-check current amounts before relying on them.

At a glance

Item	Details
Type of program	Combined Medicare and Medicaid health plan
Who runs it	Illinois Department of Healthcare and Family Services (HFS) and CMS
Age	21 and older at enrollment
Care need	Any (long-term care benefits require the usual level of care)
Illinois 2026 income rule (long-term care)	$1,330 a month (AABD standard). Income above it can be met through a spenddown
Illinois 2026 asset limit (single applicant)	$17,500
Waiting list	No

A FIDE SNP in brief

In short, a FIDE SNP is run by Illinois Department of Healthcare and Family Services (HFS) and CMS. It serves 21 and older at enrollment, and the care requirement is: Any (long-term care benefits require the usual level of care). As for waiting: No. Each of these points is covered in more depth below, alongside the general Illinois rules from our state guide. Other Illinois programs, and general guides on care at home, are linked at the end of this page for comparison with a FIDE SNP.

What the program is

HFS says FIDE SNPs are the only type of dual special needs plan available in Illinois and that they are available in every county. A FIDE SNP gives the member one card, one plan and a care coordinator for medical care and long-term care. MMAI members in some plans were moved automatically into the same company’s FIDE SNP on January 1, 2026.

Nearly everyone 65 and older on long-term care Medicaid has Medicare as well. Medicare handles most medical bills first, and Medicaid picks up long-term care and cost sharing. Integrated plans like a FIDE SNP bring the two together under one card and one coordinator. See Dual eligibility.

Who qualifies in 2026

To get a FIDE SNP, a person generally has to meet each of these:

Receives full Illinois Medicaid in the AABD or FamilyCare category
Is 21 or older at enrollment
Has Medicare Part A and Part B
Lives in the plan’s service area
Is not in an excluded group (for example, the Medicaid spend-down population or the developmental disabilities waiver)

Financial eligibility. The person must have full Illinois Medicaid in the AABD or FamilyCare category and Medicare Parts A and B. Figures shown above are the 2026 Illinois long-term care limits from our state guide. The home (up to the equity limit, when the person or a spouse lives there or plans to return), one vehicle, belongings and a small burial fund are generally not counted by Illinois HFS. Married couples get extra protection in Illinois: the spouse at home keeps a share of assets and may get some of the applicant’s income. See Spousal impoverishment rules.

What services it can pay for

The plan of care decides which services are used. A FIDE SNP can cover:

All Medicare benefits, including Part D drug coverage
Medicaid long-term services and supports, including nursing facility and waiver services
Care coordination
Extra benefits offered by the plan

The menu is broad, but the plan is built from need, and unpaid family help is factored in. If needs change, ask for a new assessment.

How to apply

Applying usually involves two decisions: one about money (financial eligibility for Medicaid) and one about care needs. In plain terms, the steps are:

Check that you have full Medicaid and Medicare Parts A and B.
Compare FIDE SNPs available in your county.
Enroll through Illinois Client Enrollment Services or the plan. Eligible members can enroll once per month.
Choose a primary care provider; the plan assigns a care coordinator.

For the paperwork, use our documents checklist before applying for a FIDE SNP; Applying for a waiver explains the general process.

Waiting lists

There is no waiting list.

More on how lists work: Waiver waiting lists.

How it relates to nursing home Medicaid

A FIDE SNP does not change Medicaid financial eligibility. People in the Medicaid spend-down population are not eligible for a FIDE SNP, which matters because many Illinois nursing home residents meet a spenddown.

What is the same as nursing home Medicaid. Illinois’s financial rules for a FIDE SNP track the nursing home rules closely. The five-year look-back still matters: a transfer for less than fair value can delay payment for long-term care services. Estate recovery also applies: the state can seek repayment from the estate of a person who received long-term care services after age 55. Under a FIDE SNP, income above an allowance may go toward the cost of care each month.

Income in a nursing home. In 2026, Illinois lets a nursing home resident keep $60 a month for personal needs; the rest of their income mostly pays toward care. Our state guide covers the nursing home rules in detail.

Choosing a plan: questions to ask

Are my current doctors, specialists, pharmacy and hospital in the plan’s network?
Are all my medications covered, and with what limits?
How do I reach my care coordinator, and how often will we talk?
How does the plan arrange home care, adult day services or a nursing home if my needs change?
Which extra benefits (dental, vision, hearing, rides) come with the plan?
How do I change plans or leave if it does not work for me?

Write down the answers and the date you asked. Plans can change their networks and extra benefits from year to year.

Tips for families

Do not wait for a crisis. Lists and assessments for a FIDE SNP take time, and the start date is usually when you first request help.
Keep copies of every a FIDE SNP form, notice and letter, and write down the name of each person you speak with and the date.
Use your appeal rights. Notices that deny or reduce services explain how to request a fair hearing; acting quickly can protect current services.
Report changes promptly, including income, assets, a move or a new living arrangement.
Mark renewal dates. Eligibility and the care plan are usually reviewed annually; see Renewals.
Get help with complex a FIDE SNP cases, such as a spouse at home or past gifts. A certified Medicaid planner or a legal aid office can review how Illinois’s rules fit a family’s situation.

Common questions

Can I leave a FIDE SNP? Yes. Dual-eligible members can go back to Original Medicare and a drug plan, with changes allowed monthly.

Is a FIDE SNP the same as MMAI? It is the replacement, with similar integration of benefits.

Am I eligible if I have a spenddown? No. The spend-down population is excluded.

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.