2023 Medicare Special Needs Plans in Texas
Find Plans in your area with your ZIP Code
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 Texas's Special Needs Plans program.
How-To Enroll in a Texas Special Needs Plan
Most people living in Texas, 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 Texas 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 Texas insurance agent. This is the best way to go if you need someone to help advise you.
If You Don't Qualify for SNP
If you don't qualify to enroll in a Special Needs Plan, you have other options, including:
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?
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 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 are the advantages of a SNP plan?
SNPs, 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 Texas, 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 .