Special Needs Plans
Special medical situations require specialized care. Medicare Special Needs Plans (or SNPs, pronounced “snips”) were created with this principle in mind.
SNPs are Advantage Plans that are tailored to meet the needs of individuals with certain health conditions or circumstances.
To qualify for a Special Needs Plan on the basis of chronic illness, the Medicare beneficiary must be diagnosed with one or more of the following conditions:
- Autoimmune disorders
- Alzheimer’s or dementia
- Cardiovascular disease, stroke, or chronic heart failure
- End-stage renal disease, requiring dialysis
- Hematologic disorders
- HIV or AIDS
- Chronic lung disorders (such as COPD)
- Chronic or disabling mental illness
- Neurologic conditions
Dual-Eligible Special Needs Plans
Dual-Eligible Special Needs Plans, or DSNPs, are available to individuals who qualify for both Medicare and Medicaid. In many cases Medicaid will pay the premiums, along with a significant portion of co-pays and deductibles.
The benefits of a DSNP include the following:
- Telemedicine services
- Transportation to appointments and pharmacies
- Dental, hearing, and vision benefits
- Gym memberships
- Quarterly benefits for over-the-counter products
Those who become eligible for a SNP at any point during the year are eligible for a Special Enrollment Period, during which they can select a SNP.
If you don’t enroll in Medicare Part D when you are first eligible for Medicare, you can elect a plan later. However, late penalties may apply. Each year, during Medicare’s Annual Election Period from October 15 to December 7, you can add, drop, or change your plan selections.