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Medicare Special Needs Plans: What are they and how do they work

Posted: June 19, 2020

Last updated date: November 17, 2020

“Special needs” is a broad term that describes people who face a wide range of challenges. Maybe you have a disability. Or a serious, ongoing medical problem. Having low income could also play a role. This article explains the different types of health plans for people with special needs. If it’s for you, a family member or you’re a caregiver, it’s good to know all your options.

Get your free dual plan guide

 Everything you need to know about Dual Special Needs Plans in one, convenient guide.

How Medicare Special Needs Plans work

Medicare Special Needs Plans (SNPs) are a type of Medicare Advantage Plan. All Medicare Advantage plans must cover the same Medicare services. But some Medicare SNPs are for people with specific diseases or challenges. These plans may tailor benefits, doctors and drug choices to match the needs of the groups they serve.

If you’re dual-eligible, it’s likely that most of your costs will be covered

The 4 types of Medicare Special Needs Plans

  1. Dual Special Needs Plans (D-SNPs) are for people who have both Medicare and Medicaid. (These people are also known as “dual-eligible.”)
  2. Chronic Special Needs Plans (C-SNPs) are for people with a severe or disabling long-term health problem. Some plans are only for people with a certain condition, like chronic heart failure, diabetes or cardiovascular disorders.
  3. Institutional Special Needs Plans (I-SNPs) are for people who live in a care facility like a nursing home, or get nursing care at home.
  4. Institutional-Equivalent Special Needs Plans (IE-SNPs) are for people who live in an assisted living facility and get the same kind of care as in a skilled nursing facility.

What’s it cost to join a Medicare Special Needs Plan

If you have both Medicaid and Medicare, it’s likely that most of your costs will be covered for you. If you don't have Medicaid, your exact costs may depend on the plan you choose. In general, you'll pay the basic costs of having a Medicare Advantage plan.

See UnitedHealthcare plans in your area.

Dual-eligible or Medicaid plan benefits can change depending on where you live. Search using your ZIP code to find the best plan to meet your health care needs.

Visit UHCMedicareSolutions.com to find out more about the C-SNPs, I-SNPs, and IE-SNPs we offer.