If you are enrolled in a Medicare Special Needs Plan (SNP) Special Needs Plans (SNPs) are Medicare Advantage Plans designed to meet specific care needs. You can only join a SNP if you fit the special needs category the plan serves. A SNP may serve people who have both Medicare and Medicaid (dual-eligibles); people who have specific chronic conditions, like diabetes; or people who live in an institution, such as a long-term care facility. , but no longer meet its eligibility requirements (for example, if you lose Medicaid Medicaid is a federal and state program that provides health coverage for certain people with limited income and assets. coverage), the SNP may continue to provide coverage for a period of time if it seems likely that you will regain eligibility for the SNP within that time. Depending on the plan, you may have between 30 days and six months to regain eligibility. If you do not regain eligibility during this time, you will be disenrolled from the SNP.
You should receive a written notice from your plan within 10 days of learning that you no longer meet your SNP’s eligibility requirements. This notice explains that you will be disenrolled if you do not regain eligibility within a certain period. If you remain ineligible, your SNP must send a second notice informing you that your coverage will be terminated.
You will have a Special Enrollment Period (SEP) to enroll in a new Medicare Advantage Medicare Advantage, also known as Part C, Medicare Private Health Plan, or Medicare Managed Care Plan, allows you to get Medicare coverage from a private health plan that contracts with the federal government. All Medicare Advantage Plans must offer at least the same benefits as Original Medicare (Part A and Part B), but can do so with different rules, costs, and coverage restrictions. Plans typically offer Part D drug coverage as part of Medicare Advantage benefits. Medicare Advantage Plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-for-Service (PFFS) plans, Special Needs Plans (SNPs), and Medicare Medical Savings Accounts (MSAs). Plan or Original Medicare Original Medicare, also known as Traditional Medicare, is the fee-for-service health insurance program offered through the federal government, which pays providers directly for the services you receive. Almost all doctors and hospitals in the U.S. accept Original Medicare. and a Part D Part D, also known as the Medicare prescription drug benefit, is the part of Medicare that provides prescription drug coverage. Part D is offered through private companies either as a stand-alone plan, for those enrolled in Original Medicare, or as a set of benefits included with a Medicare Advantage Plan. plan starting the month you no longer qualify for the SNP. To enroll in a new plan, call 1-800-MEDICARE (1-800-633-4227).