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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.

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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.

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Understand The Main Types of Special Needs Plans

C-SNPs

Chronic Condition
Special Needs Plans

Plans designed for Beneficiaries with qualifying Chronic Illnesses. Conditions include diabetes, cardiovascular disorders, chronic heart failure, cancer, HIV/AIDS, dementia & end-stage liver disease.

I-SNPs

Institutional
Special Needs Plans

Plans designed for Beneficiaries who currently reside in a full time assisted living facility or who require skilled nursing care at home.

D-SNPs

Dual
Special Needs Plans

Plans designed for Beneficiaries who qualify for both Medicare & Medicaid. These plans coordinate coverage and typically provide lower overall costs.

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The Primary Enrollment Windows

IEP

Initial Enrollment Period

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.

OEP

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.
AEP

Annual Election Period

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.

MAOEP

Medicare Advantage Open Enrollment

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.

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