Medicare Special Needs Plans in North Carolina for 2023
Find Plans in your area with your ZIP Code
To compare the Special Needs Plans available in your area, you can use our zip code lookup tool above or click on your county below. If you'd like to learn more about how the Medicare Advantage SNP program works in North Carolina and how it compares with other options, keep on reading.
How-To Enroll in a North Carolina Special Needs Plan
Most people living in North Carolina, 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 North Carolina 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 congestive heart failure might include access to a network of healthcare providers who specialize in treating congestive heart failure. 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 North Carolina insurance agent. This is the best way to go if you need someone to help advise you.
Not Qualified to Enroll in a Special Needs Plan?
Special Needs Plan are not for everyone. Fortunately, there are other options to get additional coverage. Start here:
- Medicare Advantage HMO and PPO plans
- Medicare Part D prescription drug plans
- Medigap plans for supplemental insurance
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 three types of Medicare special needs plans?
Medicare allows private health plans to offer three different types of Special Needs Plans. They include D-SNP plans for 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.... people. C-SNP plans for people with certain chronic illnesses. And I-SNP plans for institutionalized individuals.
Are SNP and D-SNP plans the same thing?
SNPs are Medicare Advantage private health plans that cater to individuals with special needs. There are three types of SNP plans: D-SNP for dual-eligible (Medicare or Medicaid) individuals; I-SNP plans to support people who are institutionalized or homeboundHomebound refers to a person who is unable to leave their home due to a medical condition. Homebound individuals can still leave home for brief periods for non-medical reasons such as graduation, family reunions, funerals, and...; and C-SNP plans that support people with certain chronic conditions. Learn how to qualify.
What do Medicare Special Needs Plans cover in North Carolina?
Like all 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). sold in North Carolina, Special Needs Plans (SNPs) must offer all of the same benefits found in Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage.. However, unlike regular Medicare Advantage plans, every SNP must include 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 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.
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 .