When you are considering a Medicare Special Needs Plan (SNP), here are some questions to keep in mind. You should also review general questions to consider before joining a Medicare Advantage Plan.

  • Am I eligible for any of the SNPs in my area?
  • How do the SNP’s services compare with those available through my current plan or other plans in my area?
  • What benefits does the SNP provide that will help with my special needs?
    • Chronic Condition SNP (C-SNP): What special services does the plan offer to help manage my condition? Does it cover specialists that I need to see?
    • Institutional SNP (I-SNP): Will the plan improve my care or experience in the nursing home? Will I have regular access to a nurse practitioner or other providers I need?
    • Dual Eligible SNP (D-SNP): Does the plan coordinate my Medicare and Medicaid benefits to make them easily accessible?
  • What costs should I expect for my coverage (premiums, deductibles, copayments)?
  • Is there an annual limit on my out-of-pocket expenses?
  • Will I be able to use my doctors? Are they in the plan’s network?
    • If I join an Institutional SNP, will the plan’s network include my nursing home or home care provider?
  • Are the plan’s in-network providers and facilities in convenient locations?
  • Does the plan provide coverage for services I receive from out-of-network providers?
  • Do I need a referral to see a specialist?
  • Are my drugs on the plan’s formulary?
  • What special accommodations does the SNP make for persons with disabilities?
  • What special language and cultural accommodations does the SNP make?

Call 1-800-MEDICARE or your State Health Insurance Assistance Program (SHIP) to find out if there is a SNP available in your area. To enroll in a SNP, call Medicare or the plan directly.

Return to: Medicare Advantage

This content was created and copyrighted by the Medicare Rights Center ©2020. Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities. These materials are presented here with support from YourMedicare.com and may not be distributed, modified or edited without Medicare Rights’ consent.

YourMedicare.com takes pride in providing you as much information as possible concerning your Medicare options, but only a health insurance broker licensed to sell Medicare can help you compare your plan options from various insurance companies. When you’re ready, we recommend you discuss your needs with a YourMedicare.com Licensed Sales Agent.