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What is a Special Needs Plan?

I have diabetes. I heard from a friend that I should check out a Medicare special plan. Can you tell me what that is?

Your friend was probably referring to a Medicare Advantage Special Needs Plan, abbreviated SNP. This type of plan is designed to meet the needs of Medicare beneficiaries in particular situations. The plans feature focused care management, special expertize of the physicians and other healthcare providers, and benefits tailored to meet special needs. For example, those with diabetes might receive special education, and nutrition and exercise programs tailored to control the disease. An SNP must also include prescription drug coverage. 

SNPs are available for three groups of beneficiaries:

  • Those eligible for both Medicare and Medicaid, known as dual-eligible beneficiaries
  • Those living in a nursing home or other institution, and
  • Those with chronic conditions, including chronic alcohol and other drug dependence, cancer, chronic heart failure, dementia, diabetes mellitus, HIV/AIDS, and stroke.

These plans are available only in some areas of the country. Check your results in the Medicare Plan Finder to determine whether there is a plan for you. 

Last updated: 12-28-2015