2023 Medicare Advantage Special Needs Plans in California
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Use our zip code lookup above to see which plans are available in your region. Or click below to select your county. Keep reading to learn more about California's Special Needs Plans program.
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 MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States..
Compare Medicare Advantage 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.
You can get enrolled three ways:
- 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:
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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-EligibleDual-eligible beneficiaries are those who receive both Medicare and Medicaid benefits. It includes beneficiaries enrolled in Medicare Part A and/or Part B while receiving full Medicaid and/or financial assistance through a Medicare Savings Program.... Special Needs Plan (D-SNP).
Are SNP and D-SNP plans the same thing?
SNPs (Special Needs Plans) are Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). for people with specific needs. There are three types: D-SNP is for dual-eligible individuals (Medicare and Medicaid), I-SNP plan for institutionalized individuals, and C–SNP plan for individuals with serious chronic health conditions. See if you qualify.
What are the advantages of a SNP plan?
SNPs, like all Medicare Advantage plans sold in California, must provide the same benefits as Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services.. But, unlike regular Medicare Advantage plans, all SNPs must provide Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... benefits for outpatient prescriptions. Other benefits are dependent on the plan type. D-SNP plans are designed to coordinate Medicare and Medicaid benefits for dual-eligible people. Many plans also cover dental, vision, and hearing.
References
medicare.gov- Medicare.gov: the official U.S. government site for Medicare | Medicare http://www.medicare.gov/
- Find a Medicare plan https://www.medicare.gov/plan-compare/
- Medicare Benefits | SSA https://www.ssa.gov/medicare/
- Extra HelpSocial Security's Low-Income Subsidy (LIS) program helps Medicare beneficiaries pay for their Medicare Part D prescription drugs by paying some of the costs. Also known as "Extra Help", beneficiaries who qualify for LIS receive premium... 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...
This Medicare Advantage Special Needs Plan state information page was last updated on .