SNP plans
Special Needs Plans coordinate care for chronic conditions (C-SNP), dual Medicare/Medicaid eligibility (D-SNP), or institutional stays (I-SNP).
What it covers
- What it pays for
- Benefits and dedicated care coordination built for qualifying chronic conditions, dual eligibility, or institutional residence.
- How it works
- Must cover all standard Medicare services plus condition-targeted extras; dedicated care management team.
- Who can get it, and when
- No medical underwriting; must meet qualifying condition/status and enroll during AEP, OEP, or applicable SEP.
What it costs
Premiums are often low for D-SNPs; cost sharing varies by SNP type. Many D-SNPs receive extra Medicaid subsidies.
Hawkins Insurance Group, LLC is not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
What is good about it
- Benefits matched to specific conditions or eligibility
The catch
- Service area restrictions
- May need to change plans if eligibility status changes
SNP plans and HMO plans
| What is compared | SNP plans | HMO plans |
|---|---|---|
| Enrollment criteria | Must qualify | Open to all |
| Care coordination | Condition-targeted | General PCP-led |
| Condition-specific extras | Yes | General extras |
Mistakes to avoid
- Assuming condition-specific extras cover all health needs. Standard medical coverage still applies
- Fewer SNP options in some areas means less plan choice and potentially fewer network providers
Common questions
- Your plan or agent can verify eligibility. D-SNPs require active Medicaid. C-SNPs require a qualifying chronic condition diagnosis.
- You will typically be disenrolled and can choose a standard Advantage plan or return to Original Medicare + Part D during a Special Enrollment Period.