Medicare Advantage Special Needs Plans
What are Medicare Advantage Special Needs Plans?
Medicare Special Needs plans cater to individuals living with conditions that need unique medical care. They fall under Medicare Advantage plans and they are divided into three distinct categories.
The types of Medicare Advantage Special Needs plans are as follows:
- Chronic Condition Special Needs Plan
This plan covers individuals living with debilitating chronic conditions. They include heart disease, autoimmune disease, HIV/AIDS, cancer, dementia, and more.
- Institutional Special Needs Plan
This plan covers Medicare beneficiaries living in healthcare institutions such as nursing homes. It also covers at-home care.
- Dual-Eligible Special Needs Plan
This Medicare plan is applicable for Medicare and Medicare beneficiaries.
Medicare special needs plans require you to have prescription drug coverage when you enroll.
What does the Medicare Advantage Special Needs plan cover?
In addition to inpatient care, skilled nursing care, hospice services, lab tests, surgery, and other Original Medicare benefits, Medicare Advantage Special Needs plans may have the following extra benefits:
- Chronic condition healthcare services and support
- Adult day-care services
- Dental, vision, and hearing
- Fitness, nutrition, and wellness programs
- Over-the-counter drugs
- Doctor’s appointment transportation
Medicare Special Needs plans provide you with the necessary coverage to make your condition more manageable. Let our licensed Medicare insurance agents will help you find the plan that best takes care of your healthcare needs.
Medicare Advantage Special Needs plan enrolment periods
You can join Medicare Advantage Special Needs plans during the following times of the year:
- Initial Coverage Election Period
The enrolment period is open between the three months before you turn 65 and three months after you turn 65.
If you are younger and living with a disability, you will be eligible for Medicare Advantage benefits 25 months after you start receiving Social Security benefits. In this case, your seven-month enrolment period begins during the first three months and the ends next three months before and after you become eligible.
- Annual Election Period
The Annual Election Period begins on October 15th and ends on December 7th. Your Medicare Advantage Special Needs coverage will begin on the 1st of January the following year and you can make changes to your Medicare Advantage plan or opt for Original Medicare coverage during this period.
- Medicare Advantage Open Enrolment Period
During this enrolment period, you can change your Medicare Special Needs plan or migrate to Original Medicare.
- Special Election Period
Special Election enrolment periods are open when individuals land in unique situations such as changing their Medicare Advantage coverage area, getting extra Medicare healthcare coverage, or moving into a nursing home. You can change your Medicare Advantage plan or return to Original Medicare during this period.