A Special Needs Plan (SNP) is a Medicare Advantage Plan (private health plan) that exclusively serves at least one of the following groups:

  • People who live in a nursing home or Intermediate Care Facility for the Mentally Retarded (either specific nursing homes or those in a certain area) and people who live in the community but require an institutional level of care;
  • People who have both Medicare and Medicaid (dual-eligibles);
  • People who have a specific chronic, severe or disabling condition defined by the plan (such as diabetes or heart disease).

SNPs should be designed to provide Medicare-covered health care and services that meet the special needs of people in the groups they serve. Examples of Special Needs Plans include plans for people with HIV/AIDS, diabetes or people who have both Medicare and Medicaid.

SNPs must include drug coverage (Medicare Part D) as part of their benefits packages.