Medicare Special Needs Plans (SNPs)

What is an Advantage Special Needs Plan?

Special Needs Plans (SNP) are Medicare Advantage Plans that are designed to treat patients with special types of chronic and severe medical conditions. SNP Plans are managed care plans similar to an HMO. These plans are managed and organized by private insurance companies. The plans must meet the rules and guidelines established by Medicare.

Why Were SNP Plans Established?

Chronically ill patients have very specialized needs. By placing the care of these patients under the management of professionals who specialize in chronically ill patients it was determined that care could be managed more effectively for patients. SNP plans try to both provide outstanding care and control costs. SNP plan membership is limited and generally a primary care physician that specializes in treating chronically ill patients will carefully monitor a patient's care. This primary care physician is usually responsible for all referrals.

What do SNP Plans Include?

SNP Plans are comprehensive health care plans. They include the services covered by Medicare Part A and Part B and they also include Part D, Prescription Drug coverage. Often SNP Plans are tailored to meet the needs of chronically ill individuals who are eligible for both Medicare and Medicaid. SNP Plan administrators are usually specialists in all the subtle rules and regulations that govern the integration of Medicare and Medicaid. SNP plans also make provisions for servicing patients who live in institutional facilities.

Medicare Patients Who Can Sign Up for a SNP Plan

SNP Plans are very specialized and the plan membership is limited to make care management as efficient as possible. Only patients with chronic and severely disabling diseases are eligible for Medicare SNP Plans. SNP Plans treat people with diabetes, chronic mental conditions, HIV/AIDS and congestive heart failure. In addition to chronic conditions, patients who are confined to institutions are often eligible for SNP Plans. Medicare recipients who are eligible for both Medicare and Medicaid can also sign up for SNP.

Each SNP Plan is unique because private health insurance companies manage these plans. When a patient is looking into a SNP Plan it is very important that they or a family member carefully investigates and compares all the details. Most of these plans are well managed but one plan may suit your particular needs better than another.