What are SNPs?
A special kind of care plan exists called a Special Needs Plan (SNP). A SNP is a type of Medicare Advantage plan offered by insurance companies for individuals who meet certain requirements. These plans have financial benefits that cover health care and prescription drugs. There are three types of Special Needs Plans:
- Chronic Special Needs plans (C-SNPs)
- Dual Special Needs plans (D-SNPs)
- Institutional Special Needs plans (I-SNPs)
Today, we will focus on Chronic and Dual Special Needs Plans.
What are C-SNPs?
A Chronic Special Needs Plan (C-SNP) is a type of SPN for people who need extra support due to severe chronic or disabling conditions. Common qualifying conditions include:
- Diabetes
- Chronic Heart Failure
- Dementia
- Stroke
Visit CMS.gov to see a full list of qualifying conditions.
TMG's Kristi Bell tells us why we are expecting to see an increase in C-SNP plans this year.
TMG Carriers with C-SNP Plans:
Benefits of C-SNP Plans
These plans offer extra benefits that Original Medicare does not such as:
- Prescription drug coverage
- Care management programs
- Low specialist cost
What are D-SNPs?
A Dual Special Needs Plan (D-SNP) is a type of SPN for people who have both Medicare and Medicaid ("dual enrolled"). This plan combines Medicare Part A, B and D prescription Drug Coverage with Medicaid to make benefits easily accessible for individuals with both.
To qualify for D-SNPs one must:
- Receive Original Medicare (Part A and B) and full Medicaid benefits
- Live in the plan's service area
- Have specific severe chronic or disabling conditions
*A person can check if they are eligible through the Medicaid office.
Changes to D-SNPs in 2025
In years past for the first 3 quarters of the year anyone maintaining dual enrollment status could change once per quarter. However, this year, if initiated by March 31, dual maintaining status will not be affective for the rest of the year.
Kristi Bell tells us how agents can best serve clients in regards to changes.
Important Enrollment Dates
- Medicare Advantage Open Enrollment: January 1 to March 31
- Open Enrollment Period: October 15 to December 7
- Special Enrollment Period: Varies depending on certain situations (ex: change of address)