Special Needs Plans (SNPs)

20.2.3 - Special Needs Plans (SNPs) (Rev. 124, Issued: 11-10-16; Effective: 11-10-16; Implementation: 11-10-16) A SNP may be offered as any of the CCP types and must satisfy CMS' SNP requirements. SNPs must exclusively enroll special needs individuals as appropriate to the SNP type (42 CFR 422.4(a)(1)(iv)). The MMA designated three specific segments of the Medicare population as special needs individuals: (1) institutionalized individuals; (2) those entitled to Medical Assistance under a State Plan under Title XIX (Medicaid) (i.e., dual eligibles); or (3) those who have “a severe or disabling chronic condition” who would “benefit from enrollment in a specialized MA plan (Section 1859 of the Act and 42 CFR 422.2). Corresponding to these segments of the Medicare population there are three types of SNPS: I-SNPs for institutionalized individuals, D-SNPs for dual eligible individuals and C-SNPs for chronic-condition individuals. See chapter 16b for more details on these requirements.