by Lois on Jul 03, 2013
Special Needs Plans (SNPs) are Medicare-approved, managed care plans designed for people with specific health care needs. The people who qualify for these Medicare Advantage (Medicare Part C) plans often need a considerable amount of medical care, so SNPs usually focus on helping members receive well-coordinated care. Special Needs Plans offer the same benefits of Original Medicare—hospital and medical insurance—along with coordinated care for specific medical conditions, such as congestive heart failure (CHF) or diabetes. By providing this specialized care coordination for those with complex health needs, these plans can help recipients stay healthier while lowering overall costs.
There are three main groups of people who qualify for a SNP:
Medicare beneficiaries who reside in a skilled nursing or assisted living facility because they cannot care for themselves:
For residents of long-term care facilities, SNPs offer specialized attention, which may include visits from nurse practitioners, and care coordinated with physicians and family members.
People with certain chronic medical conditions, such as heart disease or diabetes:
For those with certain chronic medical conditions, Special Needs Plans offer coordinated care management, dedicated specialists and nurse practitioners who create and actively manage the care plan that best meets the beneficiaries’ health care needs. This type of care can hopefully reduce hospitalizations and help beneficiaries to move to a lower risk group on the care continuum.
Dual Eligible – Medicare beneficiaries who qualify for both Medicare and Medicaid:
Medicaid is a government service that includes programs to help eligible persons pay Medicare premiums and cost sharing. If you qualify for Medicaid, there are Special Needs Plans designed especially for your unique needs and circumstances. Some SNPs serve people who are residents of long-term care facilities AND who are “dual eligible.”
If you think a Special Needs Plan may be right for you, you are eligible to join at any time throughout the year. After joining a plan, however, your enrollment period closes until the following year’s AEP
I can help you understand all your options and even see if you qualify for assistance. Contact Lois @ Advantage Benefits AZ, (602) 425-7391/ (623) 249-7238. Locally owned & operated, Glendale AZ offering all Medicare plans & option’s for AZ, NV & CA
Integra Insurance Group
13350 North 94th Drive, Suite C103
Peoria, Arizona 85381
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