Medicare Institutionalized Special Needs Plans (I-SNPs) are a specialized type of Medicare Advantage Plan designed to cater to the unique needs of individuals who require institutional-level care. These plans are tailored to provide comprehensive healthcare services to those residing in long-term care facilities.
What are I-SNPs?
I-SNPs are a subset of Special Needs Plans (SNPs) under Medicare Advantage. They specifically target individuals who have been or are expected to be in a long-term care facility for at least 90 days. These facilities can include skilled nursing facilities (SNFs), intermediate care facilities for individuals with intellectual disabilities, and inpatient psychiatric facilities
Eligibility Criteria
To be eligible for an I-SNP, an individual must:
- Have Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
- Reside in a long-term care facility or require an institutional level of care.
- Live in the plan's service area.
Benefits of I-SNPs
To be eligible for I-SNP, an individual must:
- Comprehensive Care Coordination: I-SNPs provide coordinated care services, ensuring that all aspects of a patient's healthcare are managed effectively. This includes regular health assessments and personalized care plans.
- Specialized Provider Networks: These plans often have a network of providers who specialize in caring for individuals with complex health needs.
- Additional Services: Beyond the standard Medicare Part A and Part B benefits, I-SNPs may offer extra services such as dental, vision, and hearing care, as well as wellness programs
Enrollment and Service Areas
I-SNPs operate within specific service areas, typically defined by county boundaries. These plans must have at least one long-term care facility within their service area that can accept enrollees. CMS monitors the marketing and enrollment practices of I-SNPs to prevent any discriminatory impact
Conclusion
Medicare Institutionalized Special Needs Plans play a crucial role in providing tailored healthcare services to individuals with significant care needs. By offering comprehensive care coordination, specialized provider networks, and additional services, I-SNPs ensure that their enrollees receive the best possible care in a supportive environment.
If you or a loved one might benefit from an I-SNP, it's essential to explore the available options and understand the specific benefits and services each plan offers.
If you’d like help evaluating your options, the team at URL Insurance Group is here to help. They look at your current network of doctors, your medications, and the benefits that are most important to you and find plans that match your needs. Please don’t hesitate to call 717-323-2000.
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What is the Medicare AEP and who is it for?
The Medicare Annual Enrollment Period (AEP) is when Medicare beneficiaries can add, change, or drop their Medicare Advantage Plan or Part D Prescription Drug Plan for the next year. If you already enrolled into a plan, typically around the last week of September you will receive an annual notice of change (ANOC) letter explaining how your current plan will change starting in January. This gives you enough information to start shopping and comparing plans.
The Medicare Annual Enrollment Period (AEP) is when Medicare beneficiaries can add, change, or drop their Medicare Advantage Plan or Part D Prescription Drug Plan for the next year. If you already enrolled into a plan, typically around the last week of September you will receive an annual notice of change (ANOC) letter explaining how your current plan will change starting in January. This gives you enough information to start shopping and comparing plans.
Top 5 items to review:
- Cost
- Drug costs/coverage
- Providers/networks
- Out-of-pocket estimate
- Star ratings for quality and customer service
Tip: Part D Prescription Drug coverage costs can be high on some medications. Remember that each state has extra help that you can apply for depending on your financial situation. Some manufacturers also have pharmacy assistance programs or cards that you can apply for. You could also use GoodRx. You should always carry this card with you, even if you only use it during the coverage gap.
If you are enrolled into a Medicare Supplement Insurance Plan, the AEP does not affect you. The private insurance carriers can adjust their rates at any time of the year, and you will be notified by letter. This may not occur every year. You can get a new quote for a less expensive rate at any time of the year, but it will require you to answer health underwriting questions for approval. Tip: If you consider yourself healthy and you’ve been on the same plan for over 7 years, it’s probably time to shop prices.
Most importantly, keep yourself organized by creating a mysocialsecurity.gov and mymedicare.gov account, or by using a paper folder. Having everything in one place makes it easier for an expert to assist you to the best of their ability.
If you’d like help evaluating your options, the team at URL Insurance Group is here to help. We look at your current network of doctors, your medications, and the benefits that are most important to you and find plans that match your needs. Please don’t hesitate to call us at 717-323-2000 and speak to Olivia Adkins or Eric Colello on our Medicare team to help you find the benefits you deserve.
Navigating Medicare: When to Enroll and Why It Matters
Turning 65? You may have a lot of questions about Medicare. The good news: you're not alone. The Initial Enrollment Period (IEP), starting three months before and three months after your 65th birthday, is your time to join Original Medicare (Parts A and B) without penalty.
If you have employer-sponsored health insurance with more than 20 employees, you can delay Medicare enrollment, potentially avoiding penalties. But just because you can, doesn't mean you should. Carefully compare your current plan's coverage, costs, and network with those of Medicare. Premiums, co-pays, deductibles, and doctor access all play a role in deciding what's best for you.
Unsure if you can delay? Worried you might miss the IEP deadline? Reach out to our Medicare team from URL Insurance and they can help you navigate the complex world of Medicare, compare your options, and ensure you choose the coverage that best suits your needs and budget. They'll analyze your current doctor network, medications, and priorities to find plans that fit.
Looking for Medicare help? Our Medicare partner, URL Insurance can provide:
- Medicare 101 Seminars: Gain clarity on your Medicare options in a free, informative setting.
- Personalized guidance: Get one-on-one assistance for your unique situation.
- Peace of mind: Know you've chosen the coverage that best suits your needs with help from experienced professionals.
Don't hesitate to take control of your healthcare. Attend a seminar or call 717-323-2000, and discover the Medicare benefits you deserve. Remember, Medicare may offer advantages beyond your current employer plan, so don't miss out on exploring your options!
