When you are considering a Medicare Special Needs Plan (SNP), here are some questions to keep in mind. You should also review general questions to consider before joining a Medicare Advantage Plan.

  • Am I eligible for any of the SNPs in my area?
  • How do the SNP’s services compare with those available through my current plan or other plans in my area?
  • What benefits does the SNP provide that will help with my special needs?
    • Chronic Condition SNP (C-SNP): What special services does the plan offer to help manage my condition? Does it cover specialists that I need to see?
    • Institutional SNP (I-SNP): Will the plan improve my care or experience in the nursing home? Will I have regular access to a nurse practitioner or other providers I need?
    • Dual Eligible SNP (D-SNP): Does the plan coordinate my Medicare and Medicaid benefits to make them easily accessible?
  • What costs should I expect for my coverage (premiums, deductibles, copayments)?
  • Is there an annual limit on my out-of-pocket expenses?
  • Will I be able to use my doctors? Are they in the plan’s network?
    • If I join an Institutional SNP, will the plan’s network include my nursing home or home care provider?
  • Are the plan’s in-network providers and facilities in convenient locations?
  • Does the plan provide coverage for services I receive from out-of-network providers?
  • Do I need a referral to see a specialist?
  • Are my drugs on the plan’s formulary?
  • What special accommodations does the SNP make for persons with disabilities?
  • What special language and cultural accommodations does the SNP make?

Call 1-800-MEDICARE or your State Health Insurance Assistance Program (SHIP) to find out if there is a SNP available in your area. To enroll in a SNP, call Medicare or the plan directly.