Plans & Coverage
Medicare Special Needs Plans (SNPs)
A Special Needs Plan (SNP) is a Medicare Advantage plan for people who meet specific eligibility rules and live in its service area. D-SNPs serve certain people with Medicare and Medicaid; C-SNPs serve people with qualifying chronic conditions; I-SNPs serve people who meet institutional or institutional-equivalent criteria. Benefits, costs, networks, and availability vary by plan.
Dual-eligible (D-SNP)
D-SNP eligibility depends on your Medicaid eligibility category and the plan’s service area and enrollment rules. Premiums and cost-sharing depend on your level of Medicaid assistance and the plan. Some plans may include supplemental benefits such as OTC items, food, or transportation; these are not available with every plan and may have limits. Your state Medicaid agency determines Medicaid eligibility.
Chronic Condition (C-SNP)
A C-SNP limits enrollment to people with one or more specific severe or disabling chronic conditions covered by that plan. The qualifying conditions are plan-specific, and the plan may require confirmation from a provider. Check the plan’s eligibility criteria, service area, provider network, drug coverage, and Summary of Benefits before enrolling.
Institutional (I-SNP)
An I-SNP serves people who meet the plan’s institutional or institutional-equivalent eligibility criteria, which can include living in certain institutions or meeting a qualifying need for an institutional level of care. Criteria and service areas vary. Confirm the plan’s requirements and whether its provider network serves your residence or care setting.
How to compare SNP options
All SNPs include Medicare Part A, Part B, and Part D coverage, but the plan’s premiums, cost-sharing, network, drug formulary, supplemental benefits, and eligibility rules differ. Use Medicare’s Plan Finder to see plans available for your ZIP and filter for Special Needs Plans, then confirm current details with the plan. We can help review the plan documents and your provider and prescription needs; we do not determine Medicaid or medical eligibility.
Check plans available in your area
This page is educational; it does not identify current SNPs or determine whether you meet a plan’s eligibility rules. Search Medicare’s Plan Finder by ZIP code and filter for Special Needs Plans, then verify eligibility, providers, prescriptions, benefits, and costs with the specific plan.
Questions, answered
How do I know if I qualify for a D-SNP?
You generally need Medicare Part A and Part B, to live in the plan’s service area, and to meet that D-SNP’s Medicaid-related eligibility requirements. Rules vary by plan and Medicaid category. Your state Medicaid agency determines Medicaid eligibility; we can help you review a plan’s stated requirements.
What conditions qualify for a C-SNP?
There is no single condition list that applies to every C-SNP. Each plan serves specific CMS-approved chronic conditions and may require provider confirmation. Check the plan’s current eligibility criteria and service area.
Can I use my doctors and prescriptions with an SNP?
It depends on the specific plan. SNPs may use provider networks, and drug formularies and cost-sharing vary. Confirm each doctor, facility, prescription, and pharmacy with the plan before enrolling.
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