Certain Medicare Advantage plans are designed as Special Needs Plans or SNP. These are plans that are limited to members with specific medical conditions or diseases, eligibility to reside in long term care facilities, or currently enrolled in both Medicare and Medicaid (commonly called Dual Eligible).
A Special Needs Plan is classified as one of the following three types:
Chronic Condition or C-SNP limit their members to individuals with one or more of the specified severe or chronic conditions.
Institutional or I-SNP offer their coverage to individuals who live in various residential facilities like nursing homes or require nursing care while living at home.
Dual Eligible or D-SNP provide coverage to individuals who have both Medicare and Medicaid.
If you meet the characteristics of the SNP, you can join the plan if it is available in your area. Many of the plans allow enrollment without having to wait for an annual enrollment period or the beginning of a plan year. If events change and you no longer meet the criteria of the SNP, you must disenroll and select a different Medicare option.
Like all Medicare Advantage plans, all medically-necessary and preventative care services that Original Medicare (Part A and Part B) would cover, must be covered by the SNP. Additionally, every SNP must cover prescription drugs just as Part D. However, many MA Special Needs Plans offer enhanced benefits tailored to the needs of their populations. Benefits such as dental coverage or extra days in the hospital may be offered.