Applying for Medicaid Waivers

Eligibility & Applying for Coverage

What are Special Needs Plans (SNPs)?
Special Needs Plans (SNPs) are a type of Medicare Advantage plan designed for people with unique health or financial needs. Unlike traditional Medicare or standard Advantage plans, SNPs limit enrollment to specific groups and then build their benefits and provider networks around those needs.

Who Can Qualify?

You may be eligible for an SNP if you are:

• • Dual Eligible (D-SNP): You have both Medicare and Medicaid.

  • Chronic Condition (C-SNP): You have certain severe or disabling chronic conditions, like diabetes, heart failure, or end-stage renal disease.

  • Institutionalized (I-SNP): You live in a nursing facility, assisted living, or require a nursing-home level of care at home.
    
    

Why Choose an SNP Instead of a Standard Plan?

• • Tailored Benefits: SNPs are designed around your situation. For example, D-SNPs often include dental, vision, hearing, transportation, and help coordinating Medicare and Medicaid. C-SNPs provide extra disease-specific supports.

  • Care Coordination: All SNPs must provide a personalized care plan and often include a care manager to help coordinate doctors, services, and medications.

  • Drug Coverage Included: Every SNP automatically includes Medicare Part D prescription coverage.

  • Cost Protections: SNPs may reduce out-of-pocket costs compared to piecing together separate Medicare and Medicaid coverage.
    
    

How to Apply

• • Start by confirming your eligibility (dual status, diagnosis, or care setting).

  • Compare available SNPs in your area on the Medicare Plan Finder or by contacting your State Health Insurance Assistance Program (SHIP).

  • Enroll during the regular Medicare Advantage enrollment periods, or during a Special Enrollment Period if you newly qualify (for example, if you become dual eligible).

https://www.cms.gov/medicare/enrollment-renewal/special-needs-plans