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Special Needs Plans

The Medicare Modernization Act of 2003 (MMA) established a Medicare Advantage (MA) coordinated care plan (CCP) that was specifically designed to provide targeted care to individuals with special needs. In the MMA, Congress identified "special needs individuals" as: 1) institutionalized beneficiaries; 2) dual eligibles; and/or 3) individuals with severe or disabling chronic conditions as specified by CMS. MA CCPs that are set up to provide services to these special needs individuals are called “Specialized MA plans for Special Needs Individuals,” or SNPs. SNPs offer the opportunity to improve care for Medicare beneficiaries with special needs, primarily through improved coordination and continuity of care. SNPs may be any type of MA CCP, including a health maintenance organization (HMO), or a local or regional preferred provider organization (PPO) plan.

Specific information about each of the three SNP types – dual eligible SNPs (D-SNPs), institutional SNPs (I-SNPs), and chronic condition SNPs (C-SNPs) – as well as information on the SNP Model of Care (MOC) approval process and SNP quality and enrollment – can be found by clicking the appropriate links on the left-hand side of this page. In addition, you can find links to both the Medicare Advantage and Medicare Part D Prescription Drug Program applications below.