Special Needs plans decide their own costs and these costs can vary widely. In addition to your monthly Part B premium you may pay

  • an additional premium each month for the plan
  • a deductible (the amount you pay before coverage starts)
  • a set amount or a percentage of the service cost for each doctor or hospital visit (copayment or coinsurance).
  • if you are in an HMO, the full cost for any out-of-network doctors you see or hospitals you use (except in an emergency)
  • if you are in a PPO, a higher cost if you see an out-of-network doctor

Your costs may be different if you are enrolled in programs for people with low income. For example, if you have Medicaid, SNP providers should usually not charge you Medicare copays for care. If you have Medicaid, you are automatically eligible for Extra Help.  This federal program helps pay your Medicare drug coverage premiums, deductible and copayments.

Make sure you understand exactly what the SNP is offering you before you join.