Special Needs Plan Benefits
Medicare requires MA Special Needs Plans to provide the same benefits as Parts A and B. These benefits are:
- Lab tests
- Hospice care
- Outpatient care
- Home health care
- Medical equipment
- Inpatient hospital care
- Skilled nursing facility care
- And some preventative services
But Advantage plans can offer additional benefits, such as:
- Nutrition programs
- Fitness memberships
- Over-the-counter drugs
- Adult day-care services
- Dental, Hearing, and Vision
- Transportation to doctor visits
Dual Eligible SNPs also must include Medicaid benefits in their offer or manage to provide these benefits through other options like Medicaid-managed long-term services and supports programs, Medicaid-managed care plan, or fee-for-service Medicaid. These conditions depend on your state area, so check with the insurance company first.
How Does SNP Work?
Since this type of plan combines Medicare and Medicaid benefits, it becomes easier accessible for those with lower income status, special medical conditions, and specific healthcare needs. However, Dual Eligible plans requirements can have different categories of Medicaid eligibility. These categories will determine which type of SNP-eligible individuals can choose as well as what level amount of help they will receive and what their cost-sharing amount will be.
Some special needs plans also include care-coordination services unique to your chronic condition. Wellness plans, for example, help you stick to your special diet or other activities that are designed to improve or manage your condition. Also, Dual Eligible beneficiaries have access to doctors or hospitals that specialize in treating their chronic condition. A Chronic Special Needs plan or C- SPN is designed for people with chronic conditions or other specific disabilities like diabetes, heart disease, etc.
Unlike other Medicare Advantage plans, Special Needs plans are obligated to include prescription drug coverage. Remember that the benefits you are eligible for depending on your area and plan providers. Most Dual Eligible Special Needs plan comes with 0$ premiums or no extra cost for their beneficiaries.