How to Find a Special Needs Plan in New York
While New York Medicare Part D plans are the same throughout the state, the complexity of Medicare Special Needs Plans (SNPs) requires them to be localized. The primary reason for this is that each county has different healthcare providers, and the residents have different needs, so localized plans offer the best care. SNPs are similar to Medicare Advantage plans in Suffolk County, NY, but they have different enrollment requirements.
How-To Join a Medicare Special Needs Plan in Suffolk County
Not everyone qualifies to join a SNP plan. To qualify as a person with special needs 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.
If you qualify, you can join or switch plans during a Medicare Election Period. For most people, the Annual Election Period (AEP), which starts on 15 October and ends 7 December, is the time they update their enrollment.
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.
NOTE: People sometimes ask what are the advantages and disadvantages of Medicare Advantage plans? With 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). SNP plans, it all depends on the type of plan. With SNP dual-eligible plans, the one major advantage is that almost all of your A copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service. are covered for you.
Citations & References