You're probably familiar with Medicare, but you may not know much about Medicare Special Needs Plans (SNPs), a type of Medicare plan designed for individuals with specific healthcare needs. These plans offer tailored benefits, coverage, and support for those who qualify. In this blog, we'll explore what SNPs are, who is eligible, and what they cover so you can determine if one might be right for you.
What is a Special Needs Plan Under Medicare?
A Special Needs Plan (SNP) is a type of Medicare Advantage health plan that is intended for individuals with certain chronic diseases or health care needs or who also qualify for Medicaid. "SNPs include care coordination services and tailor their benefits, provider choices, and list of covered drugs (formularies) to best meet the specific needs of the groups they serve."
Source: Special Needs Plans (SNP) | Medicare
How to Qualify for a Special Needs Plan
To qualify for a special needs plan, individuals must be enrolled in Original Medicare Parts A and B and meet the qualifying criteria for a special needs plan. We'll look at the different types of SNPs and their qualifications below.
Types of Special Needs Plans
There are 3 types of special needs plans including:
Dual Eligible SNP (D-SNP)
A Dual Eligible Special Needs Plan is for individuals who are enrolled in Medicare and qualify for Medicaid, which is a program that helps cover medical costs for some people with limited income.
Chronic Condition SNP (C-SNP)
A Chronic Condition Special Needs Plan is for individuals who have certain severe or chronic health conditions such as diabetes, dementia, heart failure, or end-stage kidney disease.
Institutional SNP (I-SNP)
An Institutional Special Needs Plan is designed for individuals who reside in a nursing home, a long-term care facility, or require an institutional level of care for at least 90 days.
What Do Special Needs Plans Cover?
Special Needs Plans (SNPs) provide the same healthcare services as all Medicare Advantage plans, including Medicare Part A and Part B. Some SNPs may offer additional benefits tailored to the specific needs of the group they serve, but all are required to include prescription drug coverage. It's important to review the details of any plan you qualify for to understand the specific benefits and services included.
How to Enroll in a Special Needs Plan with Medicare
In order to enroll in any of these Special Needs Plans, individuals must meet the qualifying criteria and be enrolled in Medicare Part A and Part B.
There are certain times when qualifying individuals can sign up for a Medicare plan or a Medicare Special Needs plan. These times include:
- Initial Enrollment Period (IEP)
- Annual Enrollment Period (AEP)
- Special Enrollment Period (SEP)
- SEPs may differ depending on your specific circumstances and the type of SNP you qualify for
Learn more about Medicare enrollment periods.
To sign up for a Medicare plan or Medicare Special Needs Plan, you can contact the insurance carrier offering the plan, work with a licensed Medicare broker, or enroll directly through the Medicare website or by calling Medicare. There are several benefits to working with a qualified Medicare broker. They can help you compare different types of Medicare plans, help you choose the plan that suits your individual needs, assist you in the process of enrolling and answer questions before and afterward.
At Twin City Underwriters, we've been helping individuals like you navigate Medicare health insurance decisions for over 50 years. If you have questions or need assistance choosing the right plan for your needs, our team is here to help guide you every step of the way. Reach out today to learn more.
Choosing a Medicare plan can be difficult. Twin City Underwriters helps Medicare recipients in Minnesota, Wisconsin, North Dakota, South Dakota, Iowa and Florida find the Medicare plan that meets their unique needs. Schedule a one-on-one meeting with one of our Medicare insurance brokers to get your questions answered!
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