Most people have heard of Medicare Advantage, but fewer know about Special Needs Plans (SNPs), Medicare Advantage plans designed around the needs of specific groups. If you qualify for one, it may coordinate your care and benefits better than a standard plan.
D-SNP: Dual Eligible Special Needs Plans
D-SNPs are for people who have both Medicare and Medicaid (in California, Medi-Cal). People with both are often called “dual eligible” or “Medi-Medi.” A D-SNP works with your Medi-Cal benefits to coordinate coverage, and many include extra benefits designed for members with limited income.
In California, many D-SNPs are called Medi-Medi Plans. With these plans, your Medicare coverage and your Medi-Cal coverage are provided through the same organization, so your care is coordinated in one place.
FIDE SNP vs. HIDE SNP
You may see these terms when comparing D-SNPs. They describe how closely a plan connects Medicare and Medicaid benefits:
- FIDE SNP (Fully Integrated Dual Eligible SNP): The same organization covers both your Medicare benefits and your Medicaid benefits, including long-term services and supports and, in many cases, behavioral health.
- HIDE SNP (Highly Integrated Dual Eligible SNP): The organization covers your Medicare benefits plus some Medicaid benefits, such as long-term services and supports or behavioral health, but not necessarily all of them.
In general, the more integrated the plan, the fewer separate cards, networks, and phone numbers you have to manage.
C-SNP: Chronic Condition Special Needs Plans
C-SNPs are for people with certain chronic conditions, such as diabetes, chronic heart failure, cardiovascular disorders, or chronic lung disease. These plans often focus on care coordination, specialists, and drug coverage related to the condition. You’ll need to confirm your condition, usually with your doctor, to enroll.
I-SNP: Institutional Special Needs Plans
I-SNPs are for people who live in, or need the level of care provided by, a nursing home or similar facility.
When can you join?
People with both Medicare and Medi-Cal, and people with Extra Help, generally have more chances to change plans during the year. Others usually enroll during the Annual Enrollment Period (October 15 to December 7) or another qualifying enrollment period.
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This article is for general educational purposes and is not a recommendation of any specific plan. Plan availability, benefits, and costs vary by plan and county and may change each year. For complete information, contact Medicare.gov or 1-800-MEDICARE.