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

Category: Annual Medicare Plan Changes
Published on 2019-09-27 15:30:56


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.


Showing the different types of Medicare Advantage Special Needs Plans( SNPs) 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.


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.)






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  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
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