Top Rated Medicare Special Needs Plans in California
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You can compare all the available Special Needs Plans in your area by using our zip code lookup tool above or by clicking on your county below. Continue reading to find out more about California's Medicare Advantage SNP program and how it compares to other options.
Do I Qualify to Enroll in a Medicare Special Needs Plan in California?
Most people living in California, age 65 and older, qualify for Medicare Advantage but do not qualify for a Special Needs Plan (SNP). A SNP is a Medicare Advantage plan, but they are only available to people with one of the following special needs:
- Chronic Condition (C-SNP): You have one or more severe or disabling chronic conditions.
- Institutional (I-SNP): You live in an institution (like a nursing home), or you require nursing care at home.
- Dual Eligible (D-SNP): You have both Medicare and Medicaid.
Compare 2025 Special Needs Plans in California by County
Each SNP limits membership to people in one of these groups or a subset of one of these groups. For instance, a SNP that's designed to serve people with diabetes mellitus might include access to a network of healthcare providers who specialize in treating this form of diabetes. Such a plan would also feature clinical case management that's designed to serve people with this condition.
There are three ways to enroll:
- Call a plan directly. If you know the plan you want, this way is quick and easy.
- Go to www.Medicare.gov and enroll through the government website. From there you can look up your medications, compare plans, and get your application started online.
- Use an independent California insurance agent. This is the best way to go if you need someone to help advise you.
If You Don't Qualify for Special Needs Benefits
If you don't qualify to enroll in a Special Needs Plan, you have other options, including:
Find Plans in your area with your ZIP Code
Frequently Asked Questions
Still have questions? These common questions and answers might help. Or, call 1-855-728-0510 (TTY 711) to speak with a licensed advisor.
What are the different types of Medicare special needs plans?
There are three types of Medicare Special Needs Plans (SNPs). Each type has different eligibility requirements. The SNP plan options are Chronic Condition Special Needs Plan (C-SNPs), Institutional Special Needs Plan (I-SNP), and Dual-Eligible Special Needs Plan (D-SNP).
What is the difference between SNP and D-SNP?
Special Needs Plans (SNPs) are Medicare Advantage private health plans designed for individuals with certain special needs. There are three different types of SNP plans, including D-SNP for dual-eligible (Medicare and Medicaid) individuals, I-SNP plans for people who are institutionalized, and C-SNP plans for individuals with certain chronic health issues. Learn more.
What are the advantages of a SNP plan?
Like all Medicare Advantage plans sold in California, Special Needs Plans (SNPs) must offer all of the same benefits found in Original Medicare. However, unlike regular Medicare Advantage plans, every SNP must include Part D benefits for prescriptions. Other plan benefits depend on the plan type. For example, most D-SNP plans coordinate Medicare and Medicaid benefits for dual-eligible plan members.
Citations & References
medicare.gov- CMS.gov, "2024 Medicare Part C Landscape Source Files", Last Accessed October 14, 2023
- Medicare.gov: the official U.S. government site for Medicare | Medicare https://www.medicare.gov/
- Find a Medicare plan https://www.medicare.gov/plan-compare/
- Medicare Benefits | SSA https://www.ssa.gov/medicare/
- Extra Help with Medicare Prescription Drug Plan Costs | SSA https://www.ssa.gov/medicare/prescriptionhelp/
- Medicare Benefits | SSA https://www.ssa.gov/benefits/medicare/
- Five-Star Quality Rating System | CMS https://www.cms.gov/medicare/provider-enrollment-and-certification/certificat...
- https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS10106.pdf
- Medicare Open Enrollment | CMS https://www.cms.gov/Outreach-and-Education/Reach-Out/Find-tools-to-help-you-h...
For details on how we research, analyze, and construct plan information for California using CMS data, see our Medicare Plan Research Methodology.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.