Do Medicare Advantage Special Needs Plans (SNPs) Offer Wellness Programs?

• by Christian Worstell
• December 4, 2023
• Reviewed by John Krahnert

What if you could get additional benefits alongside your Medicare coverage and lead a healthier life?

Medicare Advantage plans can cover certain wellness programs at no additional cost. One type of plan that can offer wellness programs is a Medicare Special Needs Plan (SNP), though not all SNPs include fitness benefits or wellness programs.

It’s important to note that Medicare SNPs are not available in all areas, and beneficiaries must meet certain criteria to qualify based on the type of SNP. Learn more about the types of SNPs and learn how to find out if you’re eligible.

What are Special Needs Plans?

Medicare SNPs are a type of Medicare Advantage plan that are tailored to serve a specific group of people and their needs.

SNPs offer the same benefits as Medicare Part A and Part B and always include prescription drug coverage.

Affordable and $0 premium SNP plans may be available in your area. However, SNPs are not as widely available as some other types of Medicare Advantage plans, and beneficiaries must meet certain eligibility requirements based on the type of SNP. Not all plans provide the same benefits, and a particular plan that fits your needs may not be available where you live.

There are three types of Medicare SNPs:

• Dual Eligible SNP (D-SNP)
  D-SNPs are for beneficiaries who qualify for both Medicare and Medicaid. D-SNPs work with state Medicaid programs to help coordinate Medicare and Medicaid benefits for qualified beneficiaries.
  
  
• Chronic Condition SNP (C-SNP)
  C-SNPs are designed to meet the needs of beneficiaries who have one or more of the following severe or disabling chronic conditions:
  • Stroke
  • Certain neurologic disorders
  • Certain chronic mental health conditions
  • Certain chronic lung disorders
  • Chronic heart failure
  • Chronic alcohol or substance dependence
  • Certain autoimmune disorders
  • Dementia
  • HIV/AIDS
  • Certain hematologic disorders
  • Diabetes
  • End-stage liver disease
  • End-stage kidney disease (ESRD) that requires dialysis
    
    
• Institutional SNP (I-SNP)
  An I-SNP is for Medicare beneficiaries who live or are expected to live for at least 90 consecutive days in a nursing home, rehab hospital, long-term care hospital, psychiatric hospital or similar facility. I-SNPs are also for beneficiaries who live in the community rather than in a facility but need the level of care one of these facilities offers.

Do I qualify?

Each SNP plan will have different rules and restrictions. SNP plans are typically limited to beneficiaries with a specific medical condition or care need, or beneficiaries who are dual eligible for Medicare and Medicaid.

You may qualify for a specific plan if you meet the following requirements:

1. You have Medicare Part A and Part B.
2. You live in the service area of a specific SNP plan.
3. You meet the requirements of the specific SNP plan.

One type of SNP is a dual eligible plan. You may qualify for this plan if you are enrolled in both Medicare and Medicaid.

A dual eligible plan works alongside your state-provided Medicaid coverage and offers additional benefits and services.

You should contact the insurance provider to learn more about the plan’s eligibility rules to see if you qualify.

What are wellness programs?

Wellness programs are benefits private health insurance plans can include that can help you live a healthier life. These types of benefits are not endorsed by the government and may not be available with plans where you live.

If you want or need a specific wellness benefit, you should ask about it before enrolling in a plan. A licensed insurance agent can help you understand your eligibility and the benefits that SNP plans in your area offer (if available).

We represent carriers such as Humana, UnitedHealthcare^®, Anthem Blue Cross and Blue Shield, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

 

 

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