Special Needs
Plans (SNP)
A Special Needs Plan, also known as a SNP plan, is a special type of Medicare Advantage plan designed for individuals dealing with specific chronic diseases, unique healthcare needs, or anyone who is on Medicaid in addition to Medicare.
Do you have special needs?
Find a plan for your situation!
The Primary Enrollment Windows
1. Initial Enrollment Period (IEP)
This is your welcome to Medicare window. It is a seven month period that centers around your 65th birthday:
- Starts 3 months before your birthday month.
- Includes your birthday month.
- Ends 3 months after your birthday month.
The "1st of the Month" Rule: If your birthday is on the first (e.g., April 1st), your entire window shifts one month earlier, beginning four months before your birthday month.
2. Medigap Open Enrollment Period
Once your Part B is active, a one time six-month window begins. During this time, you have "Guaranteed Issue" rights for a Medigap (Supplement) plan. This means:
- You cannot be denied coverage due to health history.
- You won't be charged more for pre-existing conditions.
- Once this window closes, you may have to pass a medical background check to get a plan later.
3. Annual Election Period (AEP)
Occurring every year from October 15 to December 7, this is the time to adjust your Part C (Advantage) or Part D (Drug) plans. Changes made during this time take effect on January 1 of the following year.
4. Medicare Advantage Open Enrollment (MAOEP)
From January 1 to March 31, if you are already in a Medicare Advantage plan and aren't satisfied, you can switch to a different Advantage plan or return to Original Medicare.
What is a SNP?
Special Needs Plans (SNP) are special Medicare Advantage plans offered by private insurance carriers. These plans offer everything Original Medicare does but often have different qualifications, restrictions, and costs. These plans are designed to offer additional benefits like vision and hearing care, a more robust network of specialized providers, & specific prescription drug formularies designed to meet your specific needs.
Understand The Main Types of
Special Needs Plans
CSNPs
Chronic Condition Special Needs Plans
Plans designed for Beneficiaries with qualifying Chronic Illnesses. These conditions include but are not limited to diabetes, cardiovascular disorders, chronic heart failure, cancer, HIV/AIDS, dementia & end-stage liver disease
ISNPs
Plans designed for Beneficiaries who currently reside in a full time assisted living facility or who require skilled nursing care at home.
DSNPs
Plans designed for Beneficiaries who qualify for both medicare & Medicaid. These plans coordinate coverage between the two programs and typically provide lower overall costs.
Who can enroll in it
Anyone who meets the qualifications for any of the three plans!
As long as you meet the special requirements for enrolling in a SNP plan, such as having initial dual eligibility, living in certain institutions, or being diagnosed with specific chronic conditions, and you also qualify for Original Medicare Parts A & B you can enroll in an SNP so long as you live in the plan's service area.
You can stay enrolled in the plan as long as you continue to meet the qualifications. If you lose eligibility, for any reason you will trigger a special enrollment period that gives you time to choose a different form of coverage.
Think you qualify for a Special Needs Plan?
Speak to a locally licensed insurance agent