Special Needs Plans

Special needs plans (SNP) are coordinated care (Medicare Advantage) plans designed to limit membership to beneficiaries with specific characteristics. These plans have no set enrollment periods. People who meet the requirements can enrollment at anytime. All SNPs must provide Medicare prescription drug coverage. There are 3 types of SNP’s: C-SNP, I-SNP, and D-SNP.

C-SNP

This is an SNP that is designed for people with specific chronic or disabling conditions (e.g., diabetes, End-Stage Renal Disease, HIV/AIDS, chronic heart failure, dementia, etc).

According to CMS, “approximately two-thirds of Medicare enrollees have multiple chronic conditions requiring coordination of care among primary providers, medical and mental health specialists, inpatient and outpatient facilities, and extensive ancillary services related to diagnostic testing and therapeutic management.” The detailed list of eligible chronic conditions can also be found on the CMS site.

Availability of C-SNP depends on your location. If you think one of these plans may apply to you, we will be happy to review more specifics and eligibility requirements of the plan with you. Simply leave your contact information on the right-hand side.

I-SNP

This is an SNP that is designed for people who live in certain institutions (like a nursing home) or who require nursing care at home.

Institutional Special Needs Plans (I-SNPs) limit enrollment to MA eligible individuals who have had or are expected to need the level of services provided in a long-term care (LTC) skilled nursing home, a LTC nursing home, an intermediate care facility for individuals with intellectual disabilities, or an inpatient psychiatric facility.

D-SNP

This is an SNP for individuals that are (dual) eligible for both Medicare and Medicaid. Medicaid is a joint federal and state program that provides health insurance coverage for low-income people.

If you have Medicare and Medicaid, your plan should make sure that all of the plan doctors or other health care providers you use accept Medicaid.

D-SNP enrollees can switch plans once per calendar quarter, until the 3rd quarter (end of September).

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