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Special Needs Plans are a type of Medicare Advantage Plan and are designed to meet the needs for specific groups of individuals. Most SNPs have a network of providers that beneficiaries should use whenever possible. Typically, you will be required to get your care from a doctor or facility that is in the plan’s network. All Special Needs Plans must also provide coverage for prescription drugs.
SNPs are limited when it comes to enrolling individuals into the plans. Enrollment into these plans are limited to:
Other qualifications for SNPs include living in the plan’s service area, being enrolled in Original Medicare (Parts A and B), and being a U.S. citizen or permanent resident.
As mentioned above, Dual-Eligible Special Needs Plans (D-SNP) are a type of Special Needs Plan that enrolls individuals who are eligible for both Medicare and Medicaid.
These plans combine both inpatient and outpatient coverage, as well as extra benefits, such as:
There are a few ways in which you can enroll in a D-SNP. If you are newly eligible, you can enroll at any point in the year with no restrictions. If you currently have Medicare and Medicaid or are already in a D-SNP, you can change plans during a Special Enrollment Period or the Annual Enrollment Period.
Medicare is available to individuals who are 65 and older, younger than 65 with a disability, or individuals who have End-Stage Renal Disease.
You can enroll in premium-free Medicare Part A if you are 65 or older and if you or your spouse paid Medicare taxes for no less than ten years. You can also qualify for premium-free Part A and be automatically enrolled if:
If you are under 65, you can get premium-free Part A by:
There are certain groups of people who qualify for Medicaid. Some of these groups include low-income families and individuals who get Supplemental Security Income (SSI). You must also reside in the state that you will receive Medicaid benefits from.
Other qualifications include, but not limited to:
Do you qualify for both Medicare and Medicaid and are interested in a Dual-Eligible Special Needs Plan? Midwest Trusted Benefit can help! We will make sure you get the coverage you need with the Medicare plan you deserve.