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Medicare Advantage Special Needs plans are a set of Medicare Advantage plans that serve individuals with unique needs.
To be eligible for these plans you must be enrolled in Medicare Parts A and B and meet the specific eligibility requirements the plan has.
If you think you qualify for one of these affordable health insurance plans and want to be sure of your eligibility, reach out to one of our licensed Medicare insurance agents and they can confirm your eligibility and provide you with a quick and free quote.
Medicare Advantage Special Needs plans are required by Medicaid and Medicare to provide the same benefits of Parts A and B. That is inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care, outpatient care, medical equipment, and some preventative services.
However, Advantage plans can provide additional benefits like:
Also, some Special Needs plans include care-coordination services specific to your chronic condition. Services such as wellness plans to help you understand and follow your special diet or other activities that help improve or manage your condition. You may also have access to doctors or hospitals that specialize in your chronic condition.
Another major benefit that separates Special Needs plans from other Medicare Advantage plans is that it is required to include prescription drug coverage.
Benefits you are eligible for will depend on your area and plan providers.
Initial coverage election period — Your initial coverage election period is a seven-month period that starts three months before the month you turn 65 and ends three months after the month you turn 65. If you are under 65 and receive Social Security disability, you qualify for Medicare in the 25th month after you begin receiving your Social Security benefits. If that is how you are becoming eligible for Medicare, you can enroll into an Advantage plan three months before your month of eligibility until three months after you became eligible.
Annual election period — Also known as open enrollment or AEP, the annual election period for Medicare Advantage is October 15 through December 7 every year. Coverage for the Part C plan you choose during this time will begin January 1 the next year. During this time, you can also add, change, or drop current coverage.
Medicare Advantage Open Enrollment Period — During this open enrollment period, you are able to change from one Advantage plan to another or drop it to return to Original Medicare.
Special Election Period — There are several things that can trigger a special election period and they are unique to an individual. It is best to speak to a licensed Medicare insurance agent to find out if you qualify for a special election period. However, there are a few common instances we can talk about. Such as, if you move outside your Medicare Advantage plan’s service area, qualify for extra help (such as a program that helps pay for your prescription drugs), or move into a nursing home you might qualify for a special election period. During this time you can make changes to your Advantage plan or return back to Original Medicare.
Here you are able to contact us and we can help you to determine which enrollment period you are eligible for. Give us a call today!
We would love to chat with you about your Medicare coverage. Please send us an email or give us a call and one of our local agents will follow up with you soon!
2350 South 7th Street, Saint Louis, Missouri 63104, United States
09:00 am – 05:00 pm
*Calling the number above will direct you to a licensed insurance agent. The purpose of this site is the solicitation of insurance products. Contact may be made by an insurance agent/producer or insurance company. Not affiliated with or endorsed by the government or federal Medicare program.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.