Medicare Special Needs Plans (SNPs)

[Tapdancer]

I have been looking at Part D plans and just learned that Medicare offers something called Special Needs Plans for people who have certain disabilities or chronic conditions. Are any of you familiar with these? Assuming they are HMOs, so that gives me pause. Just thought I would ask about others' experience with this for MS.

[anneth121]

I'M 65 WITH PPMS FOR MANY YEARS AND NEVER HEARD OF IT.

[Tapdancer]

Not all states offer this. Sounds like an HMO that "manages disease" and offers drugs peculiar to the illness. I didn't see MS listed specifically, just "Autoimmune Disease". I think it's more like a Medicare Advantage plan.

[onlyairfare]

I've been out of the "insurance executive" mode for a couple years, but when I was doing that, my firm decided against doing SNP's. Yes they are like Medicare Advantage in that the insurance company is paid a global set fee to care for a group of patients with a specific ailment; it's an all-inclusive fee that covers doctor visits, testing, meds, hospital admissions, etc.

It's in the company's best interest to reduce costs to be sure they don't spend more than they are paid to cover the insureds. If they are good at managing the care (reducing costs), they will be successful. If not, they lose money and will probably leave the business - that is, cancel the plan and your insurance coverage. Then you go back to whatever your original choices were.