medicare special needs plans
Are a type of Medicare Advantage plan that limits enrollment to Medicare
beneficiaries who meet specific eligibility criteria. These plans cater their
benefits to serve the unique needs of its associates.
There are three types
Of Special Needs Plans (SNPs) accessible:
Special Needs Plans (C-SNP): These
plans serve beneficiaries with certain severe or disabling chronic
conditions, such as cancer, chronic health failure, or HIV/AIDS.
Chronic-Condition Special Needs Plans can target a single chronic
condition or more than 1 condition.
Institutional Special Needs Plans (I-SNP):
These programs serve those residing in an institution (for example, a nursing home or who need nursing care in your home.
Dual-Eligible Special Needs Plans (D-SNP):
These plans serve people who have both Medicare and Medicaid benefits (also called”dual eligibles”).
Should you fall into any
Of these classes, you may have unique health-care needs that a Special Needs
Plan might be better equipped to tackle. For instance, some Special Needs Plans
offer a larger network of suppliers which focus on treating your condition
or have formularies which are tailored to cover the prescription drugs generally prescribed for your specific illness.
Some Special Needs
Plans include care-coordination services to help you understand your
condition and follow your physician’s treatment regimen. Or you might have
access to health programs to help with a particular diet or other lifestyle
actions which can help improve your condition. Chronic-Condition Special
Needs Plans might include provider networks with physicians and hospitals that
specialize in treating the specific state of its associates, or else they may have formularies that are tailored to include the prescription drugs that treat this illness. If you are enrolled in a Special Needs Plan for dual eligibles, there
may be certain social services available to assist you organize your Medicare
and Medicaid benefits.
It is important to note
That you still get all the coverage that is otherwise included with Original
Medicare, Part A and Part B, and Medicare Part D. The Special Needs Plan simply
offers extra coverage that will help you better handle your specific situation,
whether that’s residing in a nursing home; coordinating your Medicare and
Medicaid benefits; or treating a severe chronic illness.
One key difference
Between a Special Needs Plan and other types of Medicare Advantage plans is that all Special Needs Plans should cover prescription drugs. By comparison, other
Medicare Advantage plans (for instance, HMOs and PPOs) may or may not contain prescription drug coverage, based on the particular plan.
Based on the
Special Needs Plan, you will typically have the following costs:
Monthly premium to your
Extra monthly premium for
Prescription drug coverage (if your SNP needs it)
Additional benefits (if your SNP needs it)
Cost-sharing Costs, such as