What Is a Medicare Advantage Special Needs Plan?

Updated: Nov 25, 2020

Medicare Advantage plans are private health insurance plans available to seniors who qualify for Medicare. These plans cover Parts A and B of Medicare insurance and typically also include prescription drug coverage and other services such as hearing and dental that Original Medicare does not cover. Medicare Advantage Special Needs Plans are one of four common kinds of Medicare Advantage plans. The other three common types are:

· Health Maintenance Organization (HMO) Plans

· Preferred Provider Organization (PPO) Plans

· Private Fee-for-Service (PFFS) Plans

A Medicare agent at PBC can help you learn about whether a Medicare SNP is right for you, where they are offered and what type of plan is available in Hawaii. In this article we’re going to take an overall look at SNPs and how they work.


What is a Medicare Advantage Special Needs Plan

How Medicare SNPs work

Medicare SNPs are a type of Medicare Advantage Plan that only admits members who have specific diseases or characteristics. The reason for this is that Medicare SNPs provide benefits, provider choices, and drug formularies that are meant to meet the specific needs of the groups they serve.

Can I join a Medicare SNP?

You can join a Medicare SNP if you meet the following criteria:

  • You have Medicare Part A and Medicare Part B.

  • You live in the plan’s service area.