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Medicare Special Needs Plans

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Medicare Special Needs Plans 

A special kind of coordinated care plan exists called a Special Needs Plan. These are unique Medicare Advantage plans for certain qualified individuals by private insurance companies.

What are Medicare Medicare Special Needs Plans (SNPs)?

Medicare SNPs are a Medicare Advantage Plan (like an HMO or PPO). Medicare SNPs limit membership to people with particular diseases or characteristics. Medicare SNPs customize their benefits, provider choices, and drug formularies to best meet the particular requirements of the groups they serve. Find out who can join a Medicare SNP.

There are four types of Special Needs Plans:

  • Dual Special Needs Plans (D-SNPs) for individuals who have both Medicare and Medicaid (called "dual eligible")
  • Chronic Special Needs Plans (C-SNPs) for individuals living with serious or disabling chronic ailments
  • Institutional Special Needs Plans (I-SNPs) for people living in a skilled nursing facility
  • Institutional-Equivalent Special Needs Plans (IE-SNPs) for people living in a contracted assisted living establishment and require the same kind of care as those who live in a skilled nursing facility

Special Enrollment Period For SNPs

If your health needs or living circumstances change, you may need to change your Medicare Advantage plan. Under these cases, you may qualify for a Special Enrollment Period. The Special Enrollment Period is when you can enroll in a new plan if your health needs or living condition changes.

For example, if you are newly diagnosed with diabetes or a heart condition, you may qualify for an SNP. In addition, you can use the Special Enrollment Period to swap your plan.

Special Needs Plans (SNPs) are Medicare Advantage plans for individuals with limited income or specific conditions or diseases. It can be hard to have an ailment that requires extra healthcare and just as hard to cover health costs on a fixed or low income.

How do SNPs help?

Special Needs Plans cover the same healthcare services that all Medicare Advantage plans must, including Medicare Part A and B. Some SNPs may also cover extra services customized to the specific group they're devised to serve; however, all Special Needs Plans are required to provide prescription drug coverage. Therefore, you'll want to review each plan you may qualify for carefully to learn exactly what benefits and services will be covered.

Here are some ways an SNP may be able to help:

  • Additional support from a special team of care providers
  • Prescription drug coverage
  • Rides to health-related appointments
  • Complimentary healthy meals
  • Medicare Part B premium coverage

Already have a Medicare SNP? Switching is easy

It might be time to switch insurers whenever the service that your existing insurer provides doesn’t meet your needs. For example, if you have a poor claims experience or an unexplained rate increase, it might be time to consider other options

If you cancel a previous policy before a new policy is effective, you could run into some serious financial problems.

Contact us today to help you with multiple options to choose from.
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