Medicare has a whole host of plans within it to help meet the health needs of different policyholders. It starts with Original Medicare, which combines Part A and Part B to provide inpatient hospital and outpatient medical benefits. Then there’s Medicare Advantage. This is a bundled package of benefits, some of which are excluded from Original Medicare. And within Medicare Advantage, there are multiple options to choose from — assuming you qualify. Among these choices is the Medicare Advantage Special Needs Plans (SNPs).
What Are the Special Needs Plans?
Special Needs Plans are divided into three types – Dual Eligible (D-SNP), Institutional (I-SNP), and Chronic (C-SNP). Each type has its own eligibility standards because they’re inherently tailored to the people who qualify for them.
Eligibility Reminders
To be eligible for Medicare, you must be at least 65 years old, or receive disability benefits, or have been diagnosed with ALS or ESRD if you’re under 65. For Medicaid, you have to meet your state’s guidelines for Modified Adjusted Gross Income (MAGI).
What Do SNPs Have In Common?
No matter which SNP you get, it’s going to come with prescription drug coverage (Medicare Part D). This is mandatory for all SNPs, so you’ll be able to enjoy the benefits of getting your medications at lower prices.
Because these plans are sold through private insurance, there are some differences between what a plan will allow or require you to do. For example, some plans will allow for out-of-network coverage, but not to the extent that this is true in every case. However, if you’re in a plan that limits your coverage to a specific set of providers and you move outside the area, you can join a new plan during a Special Enrollment Period.
What is true for most cases, though, is that you’ll likely need to choose a primary care physician. This physician will direct the course of your treatments and will refer you to specialists when needed.
Take Advantage of the Benefits Available
At Carolina Senior Benefits, we’re dedicated to helping you get the most out of your healthcare plan. When you work with one of our licensed experts, you’ll know exactly what you’re eligible for and come out ahead with the best policy that fits your situation. Don’t miss out on the quality care and benefits that you’re entitled to — call (704) 765-4689 today.
