Medicare 101: What Are Special Needs Medicare Advantage Plans?

While the U.S. does not have universal healthcare like other countries, thankfully there are plenty of systems in place to help. One of the main programs that assist with medical costs is Medicare and Medicaid.

There are different levels of coverage within these major programs, and some expand further to help even more financially. This includes Special Needs Medicare Advantage plans.

What exactly are these plans, and how are they different from basic Medicare? Here’s everything you need to know.

Special Needs Medicare Advantage Plans 101

The special needs plan within Medicare is part of a series of Advantage Plans. Medicare Advantage Plans are in place to provide additional coverage beyond just Medicare Plan A and Plan B. With these plans, you are still receiving the aid of normal Medicare, the special needs plan is additional help.

Some within Medicare have even more of a need for more coverage than others. For example, a cancer patient battling relapse may need more financial help than someone with simply arthritis.

These plans aid significantly with costs of prescription drugs, also referred to as Plan D. Special Needs Plans, also called SNPs, are one of the more limited-availability plans and are only meant for unique circumstances.

Who is Eligible?

To be eligible for Medicare Advantage Special Needs assistance, patients will need to fall into one of three categories. Each of the three has an abbreviation, C-SNP, D-SNP, and I-SNP.

Chronic Condition plans, or C-SNP, are available for those who have a specific condition that Medicare deems particularly disabling or severe. This could include cancer, HIV/AIDS, chronic heart disease, dementia, and many more diseases. There could also be a combination of several dangerous health issues.

Then there is I-SNP, also known as Institutional plans, which cover those who are not living on their own. This can include those that are in a long-term facility, a skilled nursing facility, or a psychiatric facility.

Finally, there are dual-eligible patients, who fall under the D-SNP group. Those who have both Medicare and Medicaid are often placed in this group.

How Can I Register?

Registering for the SNP program is pretty straightforward and similar to registering for Medicare in general. You’ll need to establish that you are already Medicare advantage dual eligible, or that you already have Medicare Plans A and B.

Next, you will need a note from your doctor. The note will confirm that you have a chronic condition, or that you fall into one of the other two categories.

To enroll in the Medicare advantage special needs, you need to observe the already-established enrollment periods. Most choose to enact their Medicare around their 65th birthday, which is one of the periods.

But there are also a few more periods, including a new chance at the start of every year.

The SNP program is determined regionally. Plans for special needs vary depending on where you live.

Get the Coverage You Need

Remember, you should always stay up-to-date on Medicare and Medicaid coverage standards. Special Needs Medicare Advantage plans are in place to help with the sometimes drastic costs of prescription drugs.

If you think you are entitled to better coverage, do your research to make sure you are getting all the help that you are entitled to. For more helpful articles on business, travel, and health, check out the rest of our website.