A Special Needs Plan (SNP) is a Medicare Advantage plan designed for people with certain health conditions or coverage needs. It includes Part D drug coverage and help coordinating care. You must meet the plan’s specific eligibility rules to join.

What Are the Three SNP Types?

  • Dual Eligible SNPs, or D-SNPs, serve people with both Medicare and Medicaid.
  • Chronic Condition SNPs, or C-SNPs, serve people with one or more severe or disabling long-term conditions that the plan covers.
  • Institutional SNPs, or I-SNPs, serve people who live in a care facility or need a similar level of care while living in the community, under the plan’s rules.

You must have Part A and Part B, live in the plan's service area, and meet that plan's eligibility criteria.

For example, a person with diabetes might qualify for a C-SNP designed for that condition, while someone with full Medicaid might qualify for a D-SNP accepting that Medicaid category. An I-SNP uses rules about where you live or how much care you need. Having a diagnosis, a Medicaid card, or a need for help does not mean you qualify for every SNP. The plan must check that you meet its requirements.

How Does an SNP Work?

An SNP can be structured as an HMO or PPO. Its provider network, list of covered drugs, and extra services are designed around the group it serves. All SNPs include Part D, but premiums, your share of costs, referral rules, and out-of-network benefits vary.

You can generally remain enrolled only while you continue to meet the plan's special-needs criteria. Losing eligibility may create a Special Enrollment Period to select other coverage.

What Should You Compare?

Confirm that your doctors, hospital, pharmacy, and prescriptions work with the plan. Ask what the care coordinator actually does, which extra services require approval, and how the plan works with Medicaid or facility coverage.

Ask for a concrete description of care coordination: who checks the medication list for changes after a hospital stay, who helps arrange follow-up, and how you reach that person.

Medicare policy sources last checked: October 8, 2026.