Special Needs Plans in Medicare
SNP eligibility limited to people with certain diseases or chronic health conditions is called Chronic Condition SNP, or C-SNP. Some of these health conditions include autoimmune disease, chronic heart failure, dementia, HIV/AIDS, End-Stage Renal Disease (ESRD), etc.
SNPs are also available to individuals who reside in an institution, like nursing homes. This is called Institutional SNP or I-SNP.
Those who are enrolled in both Medicare and Medicaid may also be eligible for SNPs. This is called Dual Eligible SNP or D-SNP.
Like all other Medicare Advantage Plans, you also must be enrolled in Medicare Parts A and B to be eligible.
How SNPs Work
Those with SNPs are limited to hospitals, doctors, and other healthcare providers within their plan’s network. You must choose a primary care doctor, and you will need referrals for most specialists under this plan.
The only exception to getting out-of-network services is in the case of getting emergency care or if you have ESRD and require out-of-area dialysis.