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Special Needs Plans

Plans built around specific health and financial needs.

Special Needs Plans (SNPs) are Medicare Advantage plans designed for people with Medicare and Medicaid, certain chronic conditions, or institutional-level care needs.

Reviewed by USA Med Advantage licensed agentsSources: Medicare.gov & CMS.govUpdated for 2027
Smiling caregiver in green scrubs leaning toward an older woman
SNPs coordinate benefits, providers and drug coverage around a specific group of members.

A Special Needs Plan is a type of Medicare Advantage plan that limits membership to people with specific diseases, characteristics or circumstances. Because members share similar needs, these plans tailor their benefits, provider networks and drug formularies — and typically include a care coordinator to help you manage it all. Every SNP must include Medicare Part D prescription drug coverage.

The three types of SNPs

D-SNP

Dual Eligible

For people who have both Medicare and Medicaid. Plans coordinate both programs' benefits, and many have low or $0 cost-sharing for dual-eligible members depending on their Medicaid level.

C-SNP

Chronic Condition

For people with severe or disabling chronic conditions, such as diabetes, chronic heart failure, cardiovascular disorders, chronic lung disorders, ESRD and others approved by Medicare.

I-SNP

Institutional

For people who live in a nursing home or other institution for 90 days or longer, or who live at home but need a nursing-home level of care.

Do you have both Medicare and Medicaid?

If you qualify for both programs, you're "dual eligible." Medicaid may help pay your Medicare premiums and cost-sharing, and you may qualify for Extra Help with drug costs automatically. Dual-eligible individuals have a monthly Special Enrollment Period that lets them switch into certain integrated D-SNPs, and to change to Original Medicare with a stand-alone drug plan, in any month.

Medicare Savings Programs

Even if you don't qualify for full Medicaid, a state Medicare Savings Program may help pay Medicare costs:

  • QMB (Qualified Medicare Beneficiary) — helps pay Part A and Part B premiums, deductibles, coinsurance and copayments.
  • SLMB (Specified Low-Income Medicare Beneficiary) — helps pay Part B premiums.
  • QI (Qualifying Individual) — helps pay Part B premiums; applications are first-come, first-served each year.
  • QDWI (Qualified Disabled and Working Individuals) — helps pay Part A premiums for certain working people with disabilities.

Apply through your state Medicaid office. Income and resource limits vary by state.

Caregiver helping an older woman with a walker at home
Many SNPs include care coordination to help members manage appointments, medications and transitions.

Benefits SNPs commonly emphasize

  • A care coordinator or care team
  • Formularies built around the conditions members commonly have
  • Specialists experienced in the qualifying condition
  • Extra benefits that may include dental, vision, hearing, transportation or over-the-counter allowances (vary by plan)

How to qualify and enroll

  1. Have Medicare Part A and Part B and live in the plan's service area.
  2. Meet the plan's special-needs requirement (Medicaid eligibility, a qualifying chronic condition verified by a doctor, or institutional status).
  3. Enroll during a valid enrollment period — many SNP members qualify for Special Enrollment Periods.

If you stop qualifying (for example, you lose Medicaid), the plan must give you a grace period and you'll get a Special Enrollment Period to choose new coverage.

No cost · No obligation

Let a licensed agent do the comparing.

We'll review the Medicare Advantage plans we offer in your county — premiums, copays, out-of-pocket limits, networks and drug coverage — in one call.

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