Special Needs Plans (SNPS)
What is a Dual Special Needs Plan (D-SNP)?
Dual Special Needs Plans are for people who have both Medicare and Medicaid (called “dual eligible”). A Dual Special Needs Plan (D-SNP) is a unique Medicare Advantage plan that combines your Medicare Part A and Part B benefits, and your Medicare Part D prescription drug coverage. You’ll get extra support to help coordinate the plan with your Medicaid plan. In addition, a dual health plan provides extra benefits not provided by either Medicare or Medicaid. A dual special needs plan works together with your Medicaid health plan. You’ll keep all your Medicaid benefits. Most dual plans also give you more benefits and features than you get with Original Medicare. All for a $0 plan premium.
What is a Chronic Special Needs Plan (C-SNP)?
Chronic Special Needs Plans (C-SNPs) are for people with a severe or disabling long-term health problem. Some plans are designed only for people with a certain condition, such as for people with diabetes or chronic heart failure.
There are 15 SNP-specific chronic conditions approved by the Centers for Medicare & Medicaid Services (CMS):
Chronic alcohol and other drug dependences
Autoimmune disorders limited to: Polyarteritis nodosa, Polymyalgia rheumatica, Polymyositis, Rheumatoid arthritis and Systemic lupus erythematosus
Cancer (excluding pre-cancer conditions or in-situ status)
Cardiovascular disorders limited to: Cardiac arrhythmias, Coronary artery disease, peripheral vascular disease and Chronic venous thromboembolic disorder
Chronic heart failure
Dementia
Diabetes mellitus
End-stage liver disease
End-stage renal disease (ESRD) requiring dialysis
Severe hematologic disorders limited to: Aplastic anemia, Hemophilia, Immune thrombocytopenic purpura, Myelodysplastic syndrome and Sickle-cell disease (excluding sickle-cell trait)
HIV/AIDs
Chronic lung disorders limited to: Asthma, Chronic bronchitis, Emphysema, Pulmonary fibrosis and Pulmonary hypertension
Chronic and disabling mental health conditions limited to: Bipolar disorders, Major depressive disorders, Paranoid disorder, Schizophrenia and Schizoaffective disorder
Neurological disorders limited to: Amyotrophic lateral sclerosis (ALS), Epilepsy, Extensive paralysis (hemiplegia, quadriplegia, paraplegia, monoplegia), Huntington’s disease, Multiple sclerosis, Parkinson’s disease, Polyneuropathy, Spinal stenosis and Stroke-related neurologic deficit
Stroke
The C-SNPs available vary from company to company. You’ll need to check directly with a plan provider to see if they offer one that meets your health care needs.