Significant changes in the 2020 Medicare Advantage Special Needs Plan (SNP) landscape

Special Needs Plans (SNPs) are a type of Medicare Advantage plan with plan benefits, healthcare provider choices, and drug formularies (list of covered drugs) designed to accommodate the needs of a particular group of people meeting certain requirements - such as people suffering from a chronic condition or illness (such as diabetics or a chronic cardiac conditions) or nursing home residents or people who have limited financial resources (such as people eligible for both Medicare and Medicaid).

2020 SNPs: The Big Picture

First, based on our analysis, the bad news is that about 13% of the 2019 Medicare Advantage Special Needs Plans (SNPs) will be discontinued in 2020 — as compared to around 21% of the 2018 Special Needs Plans that were discontinued in 2019.

However, the good news is a large number of new 2020 Medicare Advantage SNPs will be introduced - and with these newly released SNPs, we will actually see an 19% increase in the total nationwide 2020 SNP landscape.  So across the country, we will see an increase in the total number of 2020 Medicare Advantage Special Needs Plans (SNPs) and SNP losses in some counties will be more than offset by SNP gains in other areas (or even the same counties).

You can see 2019/2020 SNP gains and losses with our Medicare Advantage plan comparison tool MA-Compare found at https://MA-Compare.com.

Reminder: A Medicare Advantage SNP is not designed for everyone.

Often you will find a Medicare Advantage SNP in your area that is very well-priced with feature-rich benefits and an extensive drug formulary - making the plan a very appealing coverage option.  But, please remember that you cannot join (or remain in) a Medicare Advantage SNP unless you qualify for the plan’s “Special Need” - that is, SNPs are designed for people with specific conditions, diseases, or characteristics -- and you must meet (and continue to meet) the plan's "Special Need" to be eligible for enrollment.

The types of SNPs

SNPs are divided into three major types of special need:

• Chronic Illness SNPs (like diabetes, heart disease, or ESRD),
  
  
• Dual Eligible D-SNPs (for Medicare and Medicaid beneficiaries), and
  
  
• Institutional SNPs (for Nursing and Long Term Care (LTC) residents).

From the 2020 Medicare Advantage plan information, there are a total of 855 Special Needs Plans available in 2020, the vast majority of SNPs are D-SNPs designed for people eligible for both Medicare and Medicaid.

2020 Special Needs Plans by Type of Special Need
SNP Type	2020 Plans	2019 Plans	Net Change*	% Net Change	Dropped Plans*	% of '19 SNPs Dropped	2018 Plans	2017 Plans
Chronic Illness	165	127	38	30%	8	6%	132	122
Dual Eligible	540	465	75	16%	55	12%	401	371
Institutional	150	125	25	20%	28	22%	97	87
Total	855	717	138	19%	91	13%	630	580

The chart below summarizes the 2020 Special Needs Plan landscape and how the SNP landscape has changed over the years.

You can learn more about the 2020 SNPs available in your area by using our Medicare Advantage plan finder (MA-Finder.com/2020) or add your ZIP code to the MA-Finder.com link to see plans in your area (MA-Finder.com/2020/90001).

To get you started, here is an example of all 2020 Special Needs Plans available in Allegheny County, PA.

Please note, if you are using our MA-Finder and looking for a Dual-Eligible Medicare/Medicaid SNP (D-SNP), be sure to indicate "100%" for the "LIS Subsidy Amount" to see the actual D-SNP monthly premiums for full-dual eligible Medicare/Medicaid beneficiaries.

Where are the most SNPs?

As in past years, the most Special Needs Plans are available within a few counties located in New York, Florida, and California.

Counties with the Largest Number of 2020 Special Needs Plans
Locations	SNPs
Kings County, NY	45
Queens County, NY	45
New York County, NY	43
Bronx County, NY	42
Nassau County, NY	40
Orange County, FL	38
Hillsborough County, FL	38
Pinellas County, FL	37
Seminole County, FL	36
Broward County, FL	36
Miami-Dade County, FL	35
Polk County, FL	35

A further note on Chronic Illness SNPs

Medicare Advantage Chronic Illness Special Needs Plans can be further divided into the type of chronic illness that the plan is designed to address. 

2020 Special Needs – Chronic Illness Plans Compared to the 2019 Plan Year
Chronic Illness	Number of SNPs
	2020 Plans	2019 Plans	Change	2018 Plans	2017 Plans
Cardiovascular Disorders	0	0	0	1	1
Cardiovascular Disorders & Chronic Heart Failure	10	6	4	10	10
Cardiovascular Disorders and Diabetes	2	4	-2	0	0
Cardiovascular Disorders, Chronic Heart Failure & Diabetes	67	45	22	45	40
Chronic and Disabling Mental Health Conditions	2	6	-4	2	2
Cardiovascular Disorders, Chronic Heart Failure, Diabetes Mellitus	2	2	0	2	2
Chronic Heart Failure	1	1	0	0	2
Chronic Heart Failure & Diabetes	6	5	1	6	6
Chronic Lung Disorders	16	12	4	14	13
Dementia	8	6	2	6	2
Diabetes Mellitus	37	27	10	28	27
End-stage Renal Disease Requiring Dialysis (any mode of dialysis)	10	8	2	15	15
End-stage Renal Disease Requiring Dialysis or HIV/AIDS	0	2	-2	0	0
HIV/AIDS	4	3	1	3	2
Total Chronic Illness SNPs	165	127	38	132	122

Changes within the SNP county-specific landscape

When comparing SNP reach (SNP plan multiplied by counties in the plan’s service area) we see an overall increase in plan reach.  There is a notable increase in both dual eligible and institutional SNPs and, in 2020, once again a small increase in the number of chronic illness SNPs.

2020 Special Needs Plan Reach by Type of Need
SNP Type	2020	2019	Change '19 to '20	Percent Change '19 to '20	2018	2017	2013
Chronic Illness	2,364	2,131	233	11%	2,113	2,108	6,402
Dual Eligible	11,930	9,393	2,537	27%	7,990	6,364	5,284
Institutional	1,906	1,503	403	27%	1,165	732	537
Total	16,200	13,027	3,173	24%	11,268	9,204	12,223

You can use our MA-Finder to review all 2020 Medicare Advantage Special Needs Plans available in your area (just enter your ZIP code after clicking on the link or go to MA-Finder.com to start.)