medicare special needs plans
Are a type of Medicare Advantage program that limits enrollment to Medicare
beneficiaries who meet certain eligibility standards. These programs cater their
advantages to serve the distinctive needs of its members.
There are 3 typesOf Special Needs Plans (SNPs) accessible:
Special Needs Plans (C-SNP): These
plans serve beneficiaries with specific severe or disabling chronic
conditions, such as cancer, chronic health failure, or HIV/AIDS.
Chronic-Condition Special Needs Plans may aim one chronic
condition or more than one condition.
Special Needs Plans (I-SNP):
These programs serve those residing in an institution (such as a nursing home)
or who need nursing care in your home.
If you drop into any
Of those classes, you might have unique health-care demands a Special Needs
Plan may be better equipped to tackle. By way of example, some Special Needs Plans
offer a bigger network of providers that specialize in treating your condition
or have formularies that are tailored to cover the prescription medications typically
prescribed for your specific illness.
Some Special Needs
Plans include care-coordination services to help you understand your
illness and follow your physician’s treatment regimen. Or you might have
access to health programs to aid with a particular diet or other lifestyle
activities which may assist in improving your condition. Chronic-Condition Special
Needs Plans might include provider networks with physicians and hospitals that
specialize in treating the specific state of its members, or they may have
formularies which are tailored to incorporate the prescription drugs that treat that
illness. If you are registered in a Special Needs Plan for dual eligibles, then there
could be specific social services available to help you coordinate your Medicare
and Medicaid benefits.
It is important to notice
That you get all the coverage that’s otherwise comprised with Original
Medicare, Part A and Part B, and Medicare Part D. The Special Needs Plan simply
offers extra coverage that will help you better handle your particular situation,
whether that’s residing in a nursing home; coordinating your Medicare and
Medicaid benefits; or treating a severe chronic illness.
1 key difference
Involving a Special Needs Plan and other types of Medicare Advantage programs is
that all Special Needs Plans must pay for prescription drugs. In contrast, other
Medicare Advantage plans (for example, HMOs and PPOs) may or may not include
prescription drug coverage, based on the particular plan.
Based on the
Special Needs Plan, you may typically have the following costs:
Prescription drug coverage (in case your SNP needs it)
Additional benefits (if your SNP requires it)
Cost-sharing expenses, such as
copayments, coinsurance, or deductible