Medicare Special Needs Policy Qualifications & Information
Medicare Special Needs Plans (SNPs) are a type of Medicare Advantage Plan, like an HMO or PPO, which limits membership to individuals with specific chronic diseases, or those who have specialized needs like people who have both Medicare and Medicaid. They tailor their benefits, provider choices and the list of covered drugs to best meet the specific needs of the groups they serve.
Qualifications to Join a Medicare SNP
- You are currently enrolled in Medicare Part A and Part B, live in the plan's service area OR
- You have one or more specific chronic or disabling conditions like diabetes, C.O.P.D. and others OR
- You live in an institution, like a nursing home, or you require nursing care at home OR
- You have both Medicare and Medicaid
Did You Know?
Just like other Medicare plans, if you join a Medicare SNP, there are HMO and PPO options. If you choose an HMO SNP you are required to see providers who belong to the plan, or use certain hospitals to get covered services. In most cases, you'll need referrals for specialists. The Medicare SNP will still cover emergencies or urgently needed care even if you're out of the plan's service area.