Do your Medicare clients have special needs? Special Needs Plans (SNPs) are available for Medicare enrollees who have chronic health conditions, qualify for Medicaid or need institutional care. If any of your clients fit into any of these common categories, learn how you can help them enroll in a plan that provides the extra help they need.

Chronic Conditions

Chronic Condition SNPs, or C-SNPs, are designed to cater to the needs of individuals with certain chronic conditions. In order to enroll in a C-SNP, the Medicare beneficiary must be diagnosed with the chronic condition that the C-SNP in question serves.

Different C-SNPs serve a wide range of chronic conditions, including alcohol dependence, cancer, cardiovascular disorder, diabetes, dementia, end-stage liver disease, lung disorders and stroke, as well as others. Check plans in your area for a full list of available C-SNPs.

Institutional Care

Institutional SNPs, or I-SNPs, are designed for people who require nursing care or other institutional care. Individuals who require nursing care at home may qualify for enrollment in an I-SNP.


According to KFF, one in six Medicare beneficiaries is also covered by Medicaid in Texas.

Navigating Medicare and Medicaid at the same time can be very difficult for beneficiaries. Dual Eligible SNPs, or D-SNPs, simplify this common situation through plans that are specially designed for individuals who qualify for both Medicare and Medicaid.

Low-Income Subsidies can also help qualifying Medicare enrollees afford their prescription drugs. Although some people have to apply, people who are enrolled in Original Medicare and qualify for full Medicaid benefits will qualify automatically. Watch this video to learn about Auto-Enrollment Notices.

Help Your Clients Year-Round

Health insurance is complicated, but SNPs can simplify matters for eligible enrollees. SNPs are Medicare Advantage plans, and they offer all of the services that other Medicare Advantage plans are required to cover. They may also provide additional benefits designed to meet the special needs of their enrollees. All SNPs provide prescription drug benefits, and some also have a care coordinator to help enrollees manage their healthcare.

If your clients qualify for an SNP, they will have a special enrollment period so they can enroll anytime during the year. This also makes SNPs a great opportunity for Medicare insurance agents outside of the annual election period.

Need guidance? Contact the team at PTT Financial.