Medicare Special Needs Plan Enrollment

Sponsors of Medicare Advantage health care plans approved by Medicare that accept applications for enrollment in specialized plans that limit membership to individuals with special needs, i.e., people who are living in an institution (such as a nursing home), require nursing care at home or who reside in the community but require an equivalent level of care as those residing in a long term care facility; people with both Medicare and Medicaid (dual eligibles); and/or people who have severe or disabling chronic conditions (e.g., cardiovascular disease, diabetes, congestive heart failure, mental disorders, end stage renal disease and HIV/AIDS). The plans tailor their benefits, provider choices and drug formularies (list of covered drugs) to best meet the needs of the groups they serve. The SNP offers all Medicare health care services and prescription drugs as well as more focused care that may be needed to manage a disease or condition. Participants generally must receive care from the physicians, hospitals and other providers in the SNP provider network.