Medicare Advantage Special Needs Plans
Medicare Special Needs Plans (SNP) are Advantage plans for people with specific health needs. They offer specialized care and benefits based on eligibility.
Types of Medicare Advantage Special Needs plans
There are three types of Medicare Advantage Special Needs Plans (SNPs):
Chronic-Condition Special Needs Plan — For those with specific chronic conditions like diabetes or heart disease.
Dual-Eligible Special Needs Plan — For people who qualify for both Medicare and Medicaid.
Institutional Special Needs Plan — For those living in nursing homes or needing similar long-term care.
Think you may qualify for an SNP? Contact our licensed Medicare agents to check your eligibility and get a free quote.
Medicare Advantage Benefits
Special Needs Plans (SNPs) cover everything in Medicare Parts A & B, like hospital stays, doctor visits, lab tests, and medical equipment.
They may also offer extra benefits, including:
● Dental, vision, and hearing care
● Fitness memberships
● Transportation to doctor visits
● Over-the-counter drugs
● Wellness and nutrition programs
● Support for chronic conditions
SNPs always include prescription drug coverage and may offer care coordination to help manage your health. Benefits vary by location and plan.
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When you can enroll...
You can enroll in a Medicare Advantage plan during these periods:
Initial coverage election period (ICEP) — A 7-month window starting 3 months before your 65th birthday and ending 3 months after. If you qualify due to disability, eligibility begins in your 25th month of Social Security benefits.
Annual election period (AEP) — From October 15 to December 7, you can enroll, switch, or drop a plan. Coverage starts January 1.
Medicare Advantage Open Enrollment Period — You can switch Advantage plans or return to Original Medicare.
Special Election Period (SEP) — Certain life events, like moving or qualifying for extra help, may allow you to change plans. A licensed agent can confirm if you qualify.
SNP Disenrollment Appeals Made Simple
If you receive a notice that you’re being removed from your SNP plan and disagree, you can file an appeal. An independent group, not your insurance company, will review your case.
Before appealing, ask your doctor for any helpful information. If your health is at risk, you can request a fast decision within 72 hours.
If you're discharged from a hospital too soon, you can appeal immediately. During the review, the hospital must continue your care at no cost.
SNP members in nursing homes, rehab centers, or home health care can also speed up their appeals. When you first join an SNP plan, the plan must explain the appeal process in case you’re ever removed.
Enrolling in a
SPECIAL NEEDS PLANS (SNP) PLAN
Like other Medicare Advantage plans, an SNP must provide at least the same coverage as Medicare Parts A and B, along with prescription drug benefits. However, SNPs also offer additional benefits tailored to specific medical needs.
Special Needs Plans aren't available in all areas, so you'll need to check for options in your location. You can also reach out to one of our licensed agents, who can help you find an SNP or another plan that meets your healthcare needs.
ADDITIONAL QUESTIONS TO BE ADVISED ON:
Do I qualify for an SNP based on my health condition or financial status?
You may qualify for an SNP if you have a specific chronic condition, are eligible for both Medicare and Medicaid, or need long-term care in a facility.
What extra benefits does this SNP offer beyond Original Medicare?
SNPs may offer dental, vision, hearing, prescription drugs, care coordination, transportation, wellness programs, and support for chronic conditions. Benefits vary by plan.
Are there care coordination services to help manage my condition?
Yes, SNPs offer care coordination to help manage your condition, including personalized health plans, specialist referrals, and support services.
Are my medications covered, and what are the costs?
SNPs include prescription drug coverage, but costs and covered medications vary by plan. Check the plan’s formulary (drug list) for details.
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We are not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area, and any information we provide is limited to those plans we do offer in your area. Please get in touch with Medicare.gov or 1-800-MEDICARE to get information on all your options.
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