Overview of Special Needs Plans (SNPs) in Medicare Advantage

Special Needs Plans (SNPs) are specialized Medicare Advantage plans designed to provide tailored benefits and services to individuals with severe or chronic health conditions, or those who qualify for both Medicare and Medicaid. SNPs focus on care coordination and customize their provider networks and drug formularies to meet the unique needs of their enrollees. These plans come in HMO or PPO formats and include all standard Medicare Part A and B benefits, often adding extra coverage such as extended hospital stays for critical conditions like cancer or congestive heart failure.

Enrollment in an SNP requires meeting specific eligibility criteria related to the enrollee's health status or dual eligibility for Medicaid. Availability of SNPs varies regionally since insurance carriers decide their operational areas, resulting in differing offerings across the United States. Prospective members should review specific plan details and costs since options and coverage levels differ annually and by location.