NW Florida Medicare Serving the Panhandle

Special Needs Plans

Special Needs Plans are a type of Medicare Advantage Plan. You must have Medicare Part A and Part B to be eligible.

There are 3 types of Special Needs Plans and our agents can quickly tell you if you meet the qualifications. They are also able to assist you in meeting the qualifications if you have not already qualified.

3 Types of Special Needs Plans

There are three types of Special Needs plans:

  • Dual-Eligible Special Needs Plan — A Medicare Advantage Plan for those on Medicaid. There are 4 levels of Medicaid which determine which plans you are eligible for. Many are $0 premium with $0 co-payments. We can assist you to find out what you may qualify for.
  • Institutional Special Needs Plan — The name says it all. These plans are designed for people in a Skilled Nursing Facility/Nursing Home or people limited to homebound care.
  • Chronic-Condition Special Needs Plan — If you have a Chronic Disease such as (CHF) Congestive Heart Failure, Diabetes, COPD, HIV, or many other conditions not listed you may qualify for this type of plan. These plans have a managed care and drug benefit often tailored to you Chronic Condition. They also help to minimize out of pocket cost.

If you think you qualify for one of these plans and want to be sure of your eligibility, reach out to one of our licensed Medicare insurance agents and they can confirm your eligibility and provide you with a quick and free quote.

Special Needs Benefits

 Special Needs plans are required by Medicare to provide the same benefits of Parts A and B. That is inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care, outpatient care, medical equipment, and some preventative services.

However, Special Needs Plans plans also provide additional benefits like:

  • Dental
  • Fitness memberships
  • Hearing
  • Over-the-counter drugs
  • Services and supports for those with chronic conditions
  • Transportation to doctor visits
  • Vision
  • Wellness programs

Check with one of our Medicare Specialist today to find out what you might qualify for and what plan is best for you.

Enroll in a Special Needs Plan

Special Needs Plan have different Enrollment Periods than traditional Medicare Advantage Plans. For example:

  • When you become eligible for Medicaid
  • Medicaid recipients can change plans every 3 months
  • If you qualify for (LIS) Low Income Subsidy on your medications you can also change every 3 months
  • If you have a Chronic Condition and there are plans available in your area
  • If you are admitted into a Nursing Home

There are other qualifying factors not listed so contact one of our highly trained Insurance Agents to see if you might qualify.

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