When the traditional benefits offered through Original Medicare are not enough to satisfy your unique healthcare needs, a Medicare Advantage special needs plan may help you get the coverage you need. A special needs plan offers the same Medicare services provided by all other Medicare Advantage plans but may come with additional services that fit your specific needs. Here’s what you need to know about Medicare Advantage special needs plans.
Who Can Join Medicare Special Needs Plans?
A special needs plan will generally be made available to individuals who already have Original Medicare and meet one of their desired plan’s other eligibility requirements. Some of the requirements may include the following:
Chronic Condition SNP
Individuals with certain chronic conditions may qualify for an SNP offered in their area. Some of the severe disabling conditions that may qualify you for an SNP include:
- Autoimmune disorders
- Chronic alcohol dependence
- Dementia
- End-stage liver disease
- Severe hematologic disorders
- Chronic lung disorders
- Neurologic disorders
- Stroke
- HIV/AIDS
Institutional SNP
Institutionalized individuals may also qualify for a special needs plan. This applies to people who live in an institution like a nursing home or other specialized care facility.
Dual Eligible SNP
There are also special needs plans available to people who are eligible for both Medicare and Medicaid. Ask your insurance agent for more information about dual eligibility SNP plans.
How and When To Join A Medicare Special Needs Plan
To join a Medicare Special Needs Plan, you must fall into one of the specialized groups your preferred plan covers. For example, if you are someone suffering from chronic lung conditions, the special needs plan may offer access to a network of providers that specialize in treating patients with lung problems. Their formulary would also be specifically tailored to help people with such conditions.
Insurance companies switch up their special needs plans often. Therefore various plans will be available in different areas of the country at any given time. If you have a specific chronic condition that will be best served by a special needs plan, be sure to revisit your options annually. You may find that SNP options in your area are more diverse than the last time you checked.
Find A Medicare Special Needs Plan
If you are interested in a Medicare special needs plan but don’t know where to start, reach out to the experts at Midwest Medigap for more information. Our established team of insurance professionals will help answer your questions and provide you with a free quote.
