Idaho Special Needs Plans are Organized Locally
Unlike Medicare Part D prescription drug plans, which are a statewide option, Medicare Special Needs Plans (SNPs) vary by county. The reason for this is that each county has unique needs and different healthcare resources, so county-by-county plans are the best option. Although SNPs look like other Medicare Advantage plans in Ada County, ID, they have strict enrollment requirements.
Who Can Enroll in Medicare Special Needs Plan in Ada County?
SNP plans are limited to those who qualify. To qualify as a special needs individual, you must meet one or more of the following criteria:
- An institutionalized individual,
- A dual-eligible (Medicare and Medicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States....) person, or
- An individual with a severe or disabling chronic condition.
Even if you qualify, you are only allowed to join, drop or change plans during a Medicare Election Period. The period between 15 October and 7 December is the Annual Election Period (AEP). That's when most folks make changes to their Medicare.
There's also an Individual Election Period (IEP) that you can use once. Your IEP is a 90 day period around your 65th birthday. It starts the month before you turn 65 and ends the month after.
Outside of these periods, you may be able to join a Special Needs Plan with a Special Election Period. Some situations that may qualify you for a Special Election Period include:
- You are diagnosed with a severe or disabling condition: You can enroll in a Chronic-Condition Special Needs Plan (C-SNP) for beneficiaries with your illness at any time.
- You move into a nursing home or require skilled nursing care at home: You can enroll in an Institution Special Needs Plan (I-SNP) or switch plans at any time.
- You qualify for Medicaid: If you have Medicaid or are newly eligible for Medicaid, you can enroll in a Dual-Eligible Medicare Special Needs Plan (D-SNP) at any time.
- You move outside of your existing Special Needs Plan’s service area: You'll qualify for a Special Election Period to switch to a new plan.
- Your Special Needs Plan leaves the Medicare program: You'll qualify for a Special Election Period to switch plans.
There are three ways to enroll in an SNP:
- Call our Trusted Partner at 1-855-728-0510 (TTY 711). This toll-free number is staffed by HealthCompare, the outsourced partner of choice for some of the nation’s largest health plans.
- Call a plan directly. If you know the plan you want, this way is quick and easy. All of our plan pages provide contact information.
- 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.
Citations & References
The Medicare 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).... Special Needs Plan (SNP) information in this directory originates from CMS Landscape Source Files, is maintained by David Bynon and was last updated on .