A special needs plan (or SNP, often pronounced "snip") is a category of the US

Medicare Advantage Medicare Advantage (Medicare Part C) is a type of health plan in the United States offered by private companies which was established by the Balanced Budget Act of 1997. This created a private insurance option that wraps around traditional Me ...

plan designed to attract and enroll Medicare beneficiaries who fall into a certain special needs demographic. There are two types of SNPs. The exclusive SNP enrolls only those beneficiaries who fall into the special needs demographic. The other type is the disproportionate share SNP. "Disproportionate share" SNPs enroll a greater percentage of the target special needs population as compared to a national percentage of the target population. Under the federal

Medicare Prescription Drug, Improvement, and Modernization Act The Medicare Prescription Drug, Improvement, and Modernization Act, also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health pro ...

of 2003, Congress identified special needs individuals" as (1) institutionalized, or (2) dually eligible, or (3) individuals with severe or disabling chronic conditions. More specifically, special needs individuals include: *Institutionalized beneficiaries, defined as those who reside or are expected to reside for 90 days or longer in a long-term care facility (defined as either: skilled nursing facility (SNF)/NF, ICF or inpatient psychiatric facility), or those living in the community but requiring an equivalent level of care to those residing in a long-term care facility. *Dually eligible beneficiaries, defined as individuals who are entitled to Medicare Part A and/or Part B and are eligible for some form of

Medicaid Medicaid is a government program in the United States that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by U.S. state, state governments, which also h ...

benefit. *Beneficiaries with chronic conditions, defined as individuals who have acquired one or more disabling chronic conditions, including, but not limited to:

cardiovascular disease Cardiovascular disease (CVD) is any disease involving the heart or blood vessels. CVDs constitute a class of diseases that includes: coronary artery diseases (e.g. angina, heart attack), heart failure, hypertensive heart disease, rheumati ...

diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...

congestive heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to fill with and pump blood. Although symptoms vary based on which side of the heart is affected, HF typically pr ...

osteoarthritis Osteoarthritis is a type of degenerative joint disease that results from breakdown of articular cartilage, joint cartilage and underlying bone. A form of arthritis, it is believed to be the fourth leading cause of disability in the world, affect ...

mental disorders A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is ...

, ESRD, and

HIV The human immunodeficiency viruses (HIV) are two species of '' Lentivirus'' (a subgroup of retrovirus) that infect humans. Over time, they cause acquired immunodeficiency syndrome (AIDS), a condition in which progressive failure of the im ...

AIDS The HIV, human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a Preventive healthcare, pr ...

References

*{{cite web , url=https://www.cms.gov/Medicare/Health-Plans/SpecialNeedsPlans/index.html , title=Special Needs Plans , website= Centers for Medicare & Medicaid Services , access-date= 22 April 2017 Health economics Medicare and Medicaid (United States)