Medicare Advantage I-SNPs, D-SNPs, and C-SNPs are known as Medicare Special Needs Plans, which are also a form of Medicare Advantage. Though Medicare Advantage plans generally cover the same services as Original Medicare, Special Needs Plans are modified for people with specific needs, illnesses, or diseases. 

C-SNPs

Chronic Condition Special Needs Plans (C-SNPs) are for Medicare beneficiaries who suffer from certain severe conditions such as dementia, cancer, chronic heart failure, diabetes, and epilepsy. This plan covers individuals who have conditions that are life-threatening and have a high risk of being hospitalized. 

D-SNPs

Dual-Eligible Special Needs Plans cover individuals who are eligible for both Medicare and Medicaid coverage. D-SNPs include all Medicaid eligibility categories, including full Medicaid, Specified Low-income Medicare Beneficiary, Qualifying Individual, and Qualified Medicare Beneficiary. The eligibility category may vary depending on the state. 

However, all beneficiaries eligible for Medicaid and have certain health conditions will qualify for this plan. D-SNPs offer more benefits than Original Medicare and are available in 38 states. To be eligible for D-SNPs, you must have enrolled for Original Medicare and Medicaid. Medicaid eligibility is based on income levels rather than age. D-SNPs help to cover the out-of-pocket costs the beneficiary may be responsible for under Original Medicare. 

These plans offer comprehensive benefits, and they combine various parts of Medicare, such as hospitalization, outpatient medical services, and prescription medication. If you are eligible, you can enroll for a D-SNP during the suitable Medicare enrollment period as long as the plan is available in your location. 

I-SNPs

Institutional Special Needs Plans cover beneficiaries who need to stay in an institution such as a skilled nursing facility or long-term nursing care center for at least 90 days. The acceptable list of institutions is found in the Medicare Advantage Enrollment and Disenrollment Guidance.  

To be eligible for an I-SNP, the individual must be eligible for Medicare Advantage and must reside in a state where the plan is available. They must also submit a report from an independent party that confirms the need for an institutional level of care. I-SNPs provide supplemental benefits and help to reduce the out-of-pocket costs for institutionalized beneficiaries.

For more information about Medicare Special Needs Plans, contact Game Changing Benefits.