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Medicare Special Needs Plans

Medicare Special Needs Plans in Nevada

What’s a Medicare Special Needs Plan?

Medicare Special Needs Plans (SNPs) are a type of Medicare Advantage Plan (like an HMO or PPO). Medicare SNPs limit membership to people with specific diseases or characteristics, and tailor their benefits, provider choices, and drug formularies (list of covered drugs) to best meet the specific needs of the groups they serve.

Medicare Special Needs Plan (SNPs) is designed specifically for people who:

  • Receive both Medicare and Medicaid, also known as “dual eligible”.
  • Live in a skilled Nursing facility,
  • Need the same kind of care as those live in a skilled nursing facility
  • Have specific chronic medical conditions such as Chronic alcohol and other drug dependence, Autoimmune disorders, Cancer (excluding pre-cancer conditions), Cardiovascular disorders, Chronic heart failure, Dementia, Diabetes mellitus, End-stage liver disease

Our special needs plan is available to those who qualify, either by their income level or chronic condition from Nevada.

Special needs Plans also offer supplementary benefits depending on who needs plan and what their budget needs are. These may include:

  • Routine vision and dental coverage
  • Coordination care
  • Free tests and screenings
  • Free fitness center membership
  • Routine vision coverage
  • Routine dental coverage
  • Transportation to and from approved medical appointments
  • Free rides to doctors’ appointments
  • Free comprehensive physical exams
  • Prescription drug coverage, including coverage for brand drugs
  • Credits to buy everyday health items like first aid items, vitamins and dental care products

What else do I need to know about this type of plan?

  • A plan must limit beneficiaries to these groups: 1) People who require nursing at home, or those who live in certain institutions (like nursing home) or 2) People who have disabling condition or specific chronic conditions (like diabetes, HIV/AIDS, end stage Renal disease (ESRD), chronic heart failure, or dementia), or 3) People who are eligible for Medicare and Medicaid. Plans may further limit membership, but you can join SNP at any time.
  • Plans should coordinate the providers and services you need to help you stay healthy and follow the health care provider’s order.
  • Your Plan should ensure that all of the plan doctor or other providers you use accept Medicaid.
  • If you live in an institution, ensure that the plan providers serve people where you live. You should also find out more about where SNPs are offered.

For more information about our special needs plans, please free to speak with one of our plan representatives. We look forward to hearing from you!

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