Who are Medicare Special Needs Plans for?

Special Needs Plans, or SNPs, are Medicare Advantage plans built for particular groups of people, and you have to qualify for one: • D-SNPs serve people who have Medicaid along with Medicare • C-SNPs serve people living with certain chronic illnesses, for example diabetes or heart failure • I-SNPs serve people in a nursing home, or who need nursing-home-level care while living at home The benefits and drug lists are shaped around each group.

More detail

Here's who these plans are for. Say you have diabetes and heart failure and see several specialists. A C-SNP for those conditions shapes its doctor network, drug list and care coordination around them. Or say you have both Medicare and full Medicaid. A D-SNP works with your state Medicaid program to coordinate both sets of benefits.

Things to know: • Every SNP includes Medicare drug coverage • You don't have to join one, even if you qualify • Some SNPs cover out-of-network care and some don't, so check before you join • Some limit membership to one condition or a group of related conditions • Referral and primary care doctor rules vary by plan

What to have ready: your Medicaid information if you have it, your diagnoses, your doctors and your medicines.

If you think you might qualify, let's look together at what's offered where you live.