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 Berks County, PA, they have strict enrollment requirements.
Getting Enrolled in a Berks County Medicare Special Needs Plan
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) 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.
Most of us also get an Individual Election Period (IEP), but it only comes around once. Your IEP is based on your 65th birthday. It starts the month before and ends the month after, so you have plenty of time.
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 1-855-266-4865. This toll-free number is staffed by HealthPlanOne, 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.