Medicare Advantage Plans (Part C)
Medicare Advantage plans may combine all Medicare-covered benefits with additional services, depending on the plan.
Medicare Special Needs Plans (SNPs)
What Is a Special Needs Plan?
A Special Needs Plan (SNP) is a type of Medicare Advantage Plan designed to provide targeted care for individuals with specific health conditions or circumstances. SNPs tailor their benefits, provider choices, and drug formularies to best meet the needs of the groups they serve.
Types of SNPs
There are three main types of SNPs:
1
Dual Eligible SNP (D-SNP)
For individuals who are eligible for both Medicare and Medicaid.
2
Chronic Condition SNP (C-SNP)
For individuals with specific chronic or disabling conditions such as diabetes, heart disease, or HIV/AIDS.
3
Institutional SNP (I-SNP)
For individuals who live in certain institutions like nursing homes or require nursing care at home.
Key Features
- Comprehensive Coverage
SNPs cover all Medicare Part A and Part B services. - Prescription Drug Coverage
All SNPs include Medicare Part D prescription drug coverage. - Care Coordination
SNPs often provide care coordination services to help manage your healthcare needs effectively. - Customized Provider Networks
SNPs may have networks of providers that specialize in treating the specific conditions of their members.
Eligibility Requirements
To join an SNP, you must:
- Have Medicare Part A and Part B.
- Live in the plan’s service area.
- Meet the eligibility requirements for one of the SNP types: D-SNP, C-SNP, or I-SNP.
Enrollment Information
You can enroll in an SNP during:
- The annual Medicare Open Enrollment Period (October 15 – December 7).
- A Special Enrollment Period, if you meet certain conditions such as becoming eligible for Medicaid or being diagnosed with a qualifying chronic condition.
Considerations
- Availability
SNPs are not available in all areas. Check with Medicare or a licensed insurance advisor to find out if SNPs are offered in your location. - Provider Acceptance
Not all providers accept SNPs. It’s important to verify that your preferred providers are in the plan’s network. - Continued Eligibility
You must continue to meet the specific conditions of the SNP to remain enrolled.
Provider Acceptance
Not all providers accept SNPs. It’s important to verify that your preferred providers are in the plan’s network.
Learn More
For personalized assistance and to explore SNP options in your area, consider speaking with a licensed insurance advisor. They can help you understand the benefits and determine if an SNP is right for your healthcare needs.
When are you eligible for a Medicare Advantage plan?
- If you’re 65 or older
- If you have other Medicare coverage, you can change to Medicare Advantage during annual open enrollment
- You may also qualify under other exceptions, such as an eligible disability or chronic condition
Speak To a Licensed Sales Agent
Connect with a licensed sales agent to explore your Medicare Advantage options
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We do not offer every plan available in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
[[Senior Healthcare Advisors, LLC, ], [in California – SCH Insurance Agency]] represents Medicare Advantage [HMO, PPO and PFFS] organizations [and stand-alone PDP prescription drug plans that have a Medicare contract. Members may receive a monthly or quarterly allowance benefit in the form of a prepaid card to pay for a wide range of approved [healthy groceries] [and] [utilities]. Unused amounts will expire at the end of the month or quarter. Enrollment depends on the plan’s contract renewal.
Eligibility is based on clinical criteria established by the plan. The benefits mentioned in this material may be available as part of a Special Supplemental Benefit for the Chronically Ill (SSBCI) for members with certain chronic conditions. Not all members qualify.
Not all plans offer all of these benefits. Availability and amount of these benefits vary by carrier, plan, location and service area. Not all plans offer SSBCI benefits. Limitations and exclusions may apply. [[Senior Healthcare Advisors, LLC,], [in California – SCH Insurance Agency]] not connected/endorsed by a government entity. You also agree to the Privacy Policy.
SSBCI benefits are available only to qualifying enrollees who meet the criteria for one or more of the following chronic conditions, which may include but are not limited to: congestive heart failure, diabetes, cardiovascular disorders, chronic obstructive pulmonary disease (COPD), and autoimmune disorders.
Enrollment in a plan may be limited to certain times of the year unless you qualify for a Special Enrollment Period or you are in your Medicare Initial Enrollment Period. Enrollment in a Medicare Advantage plan depends on contract renewal.