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What Are Special Needs Plans (SNPs) Under Medicare Advantage and How Do They Work?

Special Needs Plans (SNPs) are Medicare Advantage plans built for people with certain health conditions, living situations, or who qualify for both Medicare and Medicaid—designed to coordinate care and tailor benefits.

Quick takeaway

Special Needs Plans (SNPs) are a type of Medicare Advantage plan designed for people who have certain health conditions, live in specific settings, or qualify for both Medicare and Medicaid. These plans tailor benefits, provider networks, and drug formularies to support the needs of members who qualify.

Tip: Always confirm your doctors, specialists, hospitals, and pharmacies are in-network—and review the plan’s Summary of Benefits before enrolling.
Older adults reviewing Special Needs Plans (SNPs) information with an advisor.
Eligibility and plan availability vary by county and carrier.

Medicare Advantage OEP: Review Your SNP

During the Medicare Advantage Open Enrollment Period (OEP), many individuals review their Special Needs Plan (SNP) to ensure it still meets their healthcare needs. SNPs are designed to coordinate care through a primary doctor and a specialized network—helping you stay connected to doctors, clinics, and pharmacies you know and trust.

A licensed sales agent from Senior Healthcare Advisors can help explain your OEP options, review your current coverage, and guide you through possible plan changes so you can make a confident, informed decision.

Explore SNP Options
County-based availability • Network rules apply • One-on-one guidance

What Are Special Needs Plans (SNPs)?

Special Needs Plans (SNPs) are Medicare Advantage plans built for people with specific healthcare needs or circumstances. Each SNP is structured to coordinate care, support medication management, and connect members with providers who understand their particular health conditions or living situations.

Types of Special Needs Plans

Common types of Special Needs Plans include:

  • D-SNP (Dual Eligible Special Needs Plan): For people who qualify for both Medicare and Medicaid.
  • C-SNP (Chronic Condition Special Needs Plan): For individuals with certain chronic or disabling conditions.
  • I-SNP (Institutional Special Needs Plan): For people in a nursing facility or who need nursing-level care at home.

Key Features of SNPs

SNPs generally include benefits and services designed around specific health needs. Depending on the plan, features may include:

  • Coordination of care among doctors, specialists, and other providers
  • Provider networks focused on treating the conditions the plan is designed to serve
  • Prescription drug coverage supporting condition-specific treatment plans
  • Care management programs that help members follow treatment plans and manage medications
  • Extra benefits such as vision, dental, hearing, or transportation (plan-dependent)

Speak to a Licensed Sales Agent

Want help comparing SNP options in your area—eligibility rules, provider networks, and expected costs? We’ll walk you through county-based plan choices and answer your questions clearly.

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No pressure • Clear guidance • County-based options

Eligibility Requirements

To enroll in a Special Needs Plan, you must meet certain eligibility rules. In general, you must:

  • Be enrolled in Medicare Part A and Part B
  • Live in the plan’s service area
  • Meet the specific eligibility criteria for the SNP type

Enrollment Periods for SNPs

You can enroll in or change a Special Needs Plan during certain enrollment periods, including:

  • Initial Enrollment Period (IEP): When you first become eligible for Medicare.
  • Annual Enrollment Period (AEP): October 15 through December 7.
  • Medicare Advantage Open Enrollment Period (MA OEP): January 1 through March 31.
  • Special Enrollment Periods (SEPs): When qualifying life events occur (example: Medicaid changes or moving).

The availability of these enrollment periods and how they apply can depend on your situation. Always review the most current information before making changes to your coverage.

Important Things to Know About SNPs

When you are considering a Special Needs Plan, keep the following points in mind:

  • Availability varies by county and state
  • Confirm providers and pharmacies are in-network
  • You must continue meeting eligibility requirements to remain enrolled
  • You must continue paying your Part B premium (and any plan premium, unless assistance applies)

Comparing Special Needs Plans carefully can help you find coverage that supports your health needs and daily care, while coordinating services across your providers.

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