Medicare Special Needs Plans (SNPs) are a type of Medicare Advantage Plan (like an HMO or PPO). Only people with specific diseases or characteristics can enroll in an SNP. The SNPs offer the benefits, provider choices, and drug formularies (list of covered drugs) that best meet the specific needs of the groups they serve.
Your Guide to Medicare Special Needs Plans is an official government booklet that tells you about:
- how SNPs work
- services and benefits
- joining and switching
- deciding if one is right for you
If you’re in a Medicare SNP, you can file an appeal if your plan won’t pay for, doesn’t allow, stops, or limits a service you think should be covered or provided. You have the right to appeal any decision about your Medicare-covered services or extra benefits.
Your Medicare SNP must tell you in writing how to appeal. After you file an appeal, the plan will review its original decision. If your plan doesn’t decide in your favor, the appeal is reviewed by an independent organization that works for Medicare, not for the plan.