Medicare Special Needs Plans

Medicare Special Needs Plans (SNPs)d are private companies that the federal government pays to administer medicare benefits. Like all medicare advantages plan, special needs plan must provide you with the same original medicare benefits. They do however have different rules, restrictions, and costs.

Most people are starting to enroll in a medicare advantage plan. Especially for those who are eligible and would like to enjoy the benefits that are offered by medicare advantage 2020.

Like medicare advantage, special needs plans might offer you some additional benefits, such as vision and hearing care.

You are only able to join the special needs plans program if you fit the special needs category the plan serves. Special need plans may provide care and coverage coordination services not offered by other types of medicare advantage plan. Underneath are the three types of special needs plans:

1.      Chronic Condition Special Needs Plans ( C-SNPs);

These are for individuals with specific chronic conditions such as cancer, dementia, diabetes, stroke, HIV/AIDS and certain neurologic disorders.

2.      Institutional SNPs (I-SNPs);

These type of plans are for individuals who live in an institution, such as nursing home, long term care skilled nursing facilities, or assisted living facilities.

3.      Dual Eligible SNPs (D-SNPs); these are for those individuals who are enrolled in Medicare and Medicaid.

In order to join the special needs plan, you need to have both part A and part B and generally will continue paying your medicare part B premium. Some special needs plans will charge you additional surcharge on top of your plan B premium. Special needs plans also require you to be enrolled in part D coverage.

Aside from that, the plan may set their own set of deductibles, co-payments, and other cost-sharing for services. If you have Medicaid however, you should not be paying medicare deductibles and copays while seeing providers in your dual eligible SNP’s network.

There are a couple of aspects that you have to keep in mind when it comes to choosing your care. Dependable on your plan, you may have coverage for all of the network care. This is a huge advantage especially considering that plans that are being served by private insurance companies tend to be limited by their own set of hospital, doctors and care-givers network.

However, to gain this benefit, there might be a higher amount of cost that you will have to pay for.

Special needs plans can not charge more than original medicare charges for a certain type of care. This includes; chemotherapy, dialysis, and skilled nursing facilities (SNF) care. However, special needs plans can charge higher copays for other services, including home health, durable medical equipment (DME) and inpatient hospital care.

By taking this plan, you would be able to have access to a care manager who will access your needs and provide your supervision. If you are eligible for both Medicare and Medicaid, then you are able to enroll in a D-SNP.