Massachusetts Medicare-Medicaid Plan transition for health care providers

What’s changing

The Centers for Medicare & Medicaid Services (CMS) requires all Medicare-Medicaid Plans (MMP) to end Dec. 31, 2025. To help members keep their coverage, we’re moving them to an integrated Dual Eligible Special Needs Plan (D-SNP).

Starting Jan. 1, 2026, UnitedHealthcare Connected^® for One Care members will be automatically moved to the UHC One Care plan, which includes:

• UnitedHealthcare Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP) for Medicare-covered services
• UnitedHealthcare Community Plan of Massachusetts for Medicaid-covered services

Counties affected 

What you need to know

• Members will be automatically enrolled unless they choose another D-SNP. You may see new ID cards and plan names starting in January.
• Claims submission and prior authorization are not changing. We’ll coordinate Medicare and Medicaid benefits internally.
  • For electronic claims and prior authorization requests, sign in to the UnitedHealthcare Provider Portal with your One Healthcare ID. Select the Claims & Payments tab to submit claims and the Prior Authorizations tab to submit and manage authorizations requests.
  • For paper claims, use the address on the back of the member’s ID card
  • Payer ID will remain 87726
• All health care professionals and facilities must have a current Massachusetts Medicaid ID number to provide care to Community Plan members
• If you don’t have a Medicaid ID number, you can apply online at Mass.gov:
  • Download and complete the MassHealth Nonbilling Managed Care Entity Network-only Provider Contract
  • Upload and submit the completed form

Additional resources

• Medicare – Administrative Guide
• Medicaid – Massachusetts Care Provider Manual

Questions? We’re here to help.

Connect with us through chat 24/7 in the  UnitedHealthcare Provider Portal.