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Significant changes in the 2021 Medicare Advantage Special Needs Plan (SNP) landscape

Category: Annual Medicare Plan Changes
Published on 2020-09-28 16:33:00

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).

The Big Picture: More 2021 SNP options

First, based on our analysis, the bad news is that about 15% of the 2020 Medicare Advantage Special Needs Plans (SNPs) will be discontinued in 2021 — as compared to around 13% of the 2019 Special Needs Plans that were discontinued in 2020.

However, the good news is a large number of new 2021 Medicare Advantage SNPs will be introduced - and with these newly released SNPs, we will actually see an 14% increase in the total nationwide 2021 SNP landscape, with a 23% increase in chronic illness SNPs (c-SNPs).  The vast majority of SNPs remains Dual-Eligible (D-SNPs) (61%). 

Across the country, we will see an increase in the total number of 2021 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 2020/2021 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 2021 Special Needs Plans

SNPs are divided into three major types of special need:
  • Chronic Illness SNPs or C-SNPs (like diabetes, heart disease, or ESRD),

  • Dual Eligible Medicare/Medicaid SNPs or D-SNPs (for Medicare and Medicaid beneficiaries), and

  • Institutional SNPs (for Nursing and Long Term Care (LTC) residents).
From the 2021 Medicare Advantage plan information, there are a total of 975 Special Needs Plans available across the country in 2021.  And as can be seen below, the vast majority of SNPs are D-SNPs designed for people eligible for both Medicare and Medicaid.

2021 Special Needs Medicare Advantage Plans
by Type of Special Need
SNP Type 2021 Plans
2020 Plans Net Change* % Net Change Dropped Plans* % of '20 SNPs Dropped 2019 Plans 2018 Plans
Chronic Illness 203 165 38 23% 25 15% 127 132
Dual Eligible 598 540 58 11% 78 14% 465 401
Institutional 174 150 24 16% 23 15% 125 97
Total 975 855 120 14% 126 15% 580 630

The chart below summarizes the 2021 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 2021 SNPs available in your area by using our Medicare Advantage plan finder (MA-Finder.com/2021) or add your ZIP code to the MA-Finder.com link to see plans in your area (MA-Finder.com/2021/90001).

To get you started, here is an example of all 2021 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.

Question:  In what counties can we find 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 (C-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. 

2021 Special Needs – Chronic Illness Plans
Compared to the 2020 Plan Year
Chronic Illness Number of SNPs
2021 Plans 2020 Plans Net Change 2019 Plans 2018 Plans
Cardiovascular Disorders 1 0 1 0 1
Cardiovascular Disorders & Chronic Heart Failure 14 10 4 6 10
Cardiovascular Disorders and Diabetes 6 2 4 4 0
Cardiovascular Disorders, Chronic Heart Failure & Diabetes 3 67 -64 45 45
Chronic and Disabling Mental Health Conditions 93 2 91 6 2
Cardiovascular Disorders, Chronic Heart Failure, Diabetes Mellitus 3 2 1 2 2
Chronic Heart Failure 3 1 2 1 0
Chronic Heart Failure & Diabetes 3 6 -3 5 6
Chronic Lung Disorders 23 16 7 12 14
Dementia 7 8 -1 6 6
Diabetes Mellitus 34 37 -3 27 28
End-stage Renal Disease Requiring Dialysis (any mode of dialysis) 9 10 -1 8 15
End-stage Renal Disease Requiring Dialysis or HIV/AIDS 4 0 4 2 0
HIV/AIDS 0 4 -4 3 3
Total Chronic Illness SNPs 203 165 38 127 132

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 SNPs and a small increase in the number of chronic illness and institutional SNPs.

2021 Special Needs Plan Reach
by Type of Need
SNP Type 2021 2020 Change '20 to '21 Percent Change '20 to '21 2019 2018 2013
Chronic Illness 2,667 2,364 303 13% 2,131 2,113 6,402
Dual Eligible 15,235 11,930 3,305 28% 9,393 7,990 5,284
Institutional 2,441 1,906 535 28% 1,503 1,165 537
Total 20,343 16,200 4,143 26% 13,027 11,268 12,223

You can use our MA-Finder to review all 2021 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.)

To learn more about Special Needs Plans in your area, please call Medicare at 1-800-633-4227 and speak with a Medicare representative about your Medicare plan options.

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Tips & Disclaimers
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  • 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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