| Special Needs Plans (SNPs) were created to encourage greater access to healthcare for certain populations: the institutionalized, persons dually eligible for Medicare and Medicaid, and the chronically ill. Not all Health Plans offer SNPs.
Enrolling in a SNP
Under the Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003, Congress authorized 3 main types of SNPs. Eligibility is determined by the type of SNP.
- Disease-Specific Plan. This type of plan focuses on the specific health needs of people who have certain chronic conditions like diabetes or congestive heart failure. To enroll in this type of SNP, you must have one or more of the specific chronic conditions that the plan is designed to address.
- Dual-Eligible Plan. This type of plan offers reduced monthly plan premiums and copayments or coinsurance costs, and includes additional services and benefits like transportation. To enroll in this type of SNP, you must be eligible for both Medicare and Medicaid (“Dual Eligible”).
- Institutional Plan. This type of plan is designed to meet the specific needs of those living in nursing homes or long-term care facilities. To be enroll in this type of SNP, you must live in certain institutions or require nursing care at home.
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