What Are Medicare Special Needs Plans?

Did you know that there are Medicare Special Needs Plans?

Medicare Advantage Plan SNP (Medicare Special Needs Plans) catered for people with certain special needs. Medicare SNPs limit the membership to people with specific diseases or characteristics. Medicare SNPs tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve.

Learn more about Medicare Special Needs Plans: 

The three different SNP plans cover Medicare beneficiaries living in institutions or senior home facilities, those who are dual-eligible that qualifies for both Medicaid and Medicare, and those with chronic conditions such as diabetes, heart condition and or End Stage Renal Disease (ESRD), or HIV/AIDS. Moreover, this type of plan always includes coverage for prescription drugs and most have vision, nurse help line, worldwide coverage and more. Unlike regular Medicare Advantage Plans, you need to meet the criteria to enroll on these type of Medicare Advantage plans.

Qualifications for Medicare SNP:

• You have Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance).
• You live in the plan’s service area.
• You meet the plan’s eligibility requirements, like one of these:

Chronic Condition SNP (C-SNP): You have one or more of these severe or disabling chronic conditions:
Chronic alcohol and other dependence
Autoimmune disorders
Cancer (excluding pre-cancer conditions)
Cardiovascular disorders
Chronic heart failure
Dementia
Diabetes mellitus
End-stage liver disease
End-Stage Renal Disease (ESRD) requiring dialysis (any mode of dialysis) 
Severe hematologic disorders
HIV/AIDS
Chronic lung disorders
Chronic and disabling mental health conditions
Neurologic disorders
Stroke

• Institutional SNP (I-SNP): You live in an institution (like a nursing home), or you require nursing care at home.
• Dual Eligible SNP (D-SNP): You have both Medicare and Medicaid.

Paying for Medicare SNP:

If you have Medicare and Medicaid, most of the costs of joining a Medicare SNP will be covered for you. Contact your Medicaid office for more information and to see if you qualify for Medicaid benefits.