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A Complete Guide To Medicare Special Needs Plans

A Complete Guide To Medicare Special Needs Plans Medicare is an essential part of the American healthcare system. It’s a federally funded program that provides health insurance to people 65…

November 18, 2022

Written by Nikki Grillo

A Complete Guide To Medicare Special Needs Plans

Medicare is an essential part of the American healthcare system. It’s a federally funded program that provides health insurance to people 65 or older and those with specific disabilities. While the coverage provided by Medicare is extensive, some people might be looking for more specialized care; that’s where Special Needs Plans (SNPs) come in.

Perhaps you might find that you or someone you know needs an SNP to get the most out of their Medicare coverage. Therefore, we’ve put together a complete guide to Medicare SNPs, including what they cover, who can benefit from them, eligibility, and more. Keep reading!

What Is A Medicare SNP, And How Does It Work?

As we mentioned, a Medicare SNP is a Medicare Advantage plan. That means it’s an alternative to traditional Medicare coverage, and private insurance companies approved by Medicare offer it. These plans must provide at least the same level of coverage as Original Medicare (Parts A and B, or hospital and medical insurance), but they can also offer additional benefits.

One key difference between SNPs and other types of Medicare Advantage plans is that SNPs aim to meet the specific health needs of particular groups. For example, there might be an SNP for people with diabetes or one for those living in a nursing home. The plan will include extra features and services that help members manage their particular conditions.

SNP Eligibility: What Are The Different SNP Types?

There are three different types of SNP:

  • Institutional SNPs provide coverage for people who live in a nursing home or long-term care facility.
  • Prescription Drug SNPs offer extra prescription drug coverage for people with specific chronic conditions, such as heart disease, diabetes, or Alzheimer’s.
  • Dual Eligible SNPs give extra help to people who have both Medicare and Medicaid coverage (also known as “dual eligible” or “dual beneficiaries”).

You might be wondering if you’re eligible for an SNP. The answer depends on which type of SNP you’re interested in. Generally, you must meet the following criteria:

  • You must first enroll in Original Medicare.
  • You must reside within the SNP’s service area.
  • You must not have End-Stage Renal Disease (unless you want to enroll in a Dual Eligible SNP).

Now that you know what an SNP is and who’s eligible for one let’s explore some of its benefits.

What Are The Benefits Of Joining A SNP?

Here are some of the most common benefits you can expect from joining an SNP:

A More Personalized Care Experience

Because SNPs aim to meet specific needs, you can expect a more personalized care experience overall. For instance, if you join a Prescription Drug SNP, the plan will work with your doctors to ensure you get the proper medications and dosage levels.

Better Coordination Of Services

One goal of SNPs is to help members coordinate their care to get all the services they need from different providers. These services might include home health care, transportation assistance, or help to find specialists in your area.

Extra Benefits Not Covered By Original Medicare

In addition to the benefits we’ve already mentioned, you might also be able to get extra services that Original Medicare doesn’t cover. These benefits can vary depending on the SNP, but they might include dental care, vision services, or fitness programs.

How To Enroll In An SNP

Enrolling in an SNP is similar to enrolling in any other type of Medicare Advantage plan. First, research the different programs available in your area to see which one best meets your needs. Once you’ve found a few that seem like a good fit, you can contact the insurance companies directly to get more information.

When you’re ready to enroll, you’ll need to fill out a Medicare Advantage application and submit it to the insurance company. You can do this online, over the phone, or in person. Once your application is approved, you’ll be officially enrolled in the SNP and can start using your benefits.

Nesso Senior Benefits – We Help You Find The Right Health Insurance Plan

At Nesso Senior Benefits, we understand how confusing and overwhelming the process of choosing a health insurance plan can be; that’s why we’re here to help. Our experienced and professional insurance agents will work with you to find the right Medicare plan, including a Special Needs Medicare if that’s what’s best for you. Contact the Nesso Group today; we’ll be happy to answer any of your questions!


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