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Senior Citizen's Guide to Pittsburgh

Help for the Most Vulnerable is Available with Special Needs Plans

By Austin Ifedirah, V.P., Medicare and Strategic Planning, Gateway Health Plan

The choice is not always simple…
Are you 65 + and looking for the best Medicare plan? Are you chronically ill or disabled and worried about how you are going to pay for your medications? When living with a chronic condition or on a fixed income, it can be daunting to choose one health plan among many. Do you worry that you may be running out of time? If you have asked yourself any of these questions, a Special Needs Plan (SNP) may be just what the doctor ordered. But what are SNPs exactly? 

According to the U.S. Centers for Medicare and Medicaid Services, nearly 9 million of Medicare’s 49 million beneficiaries also qualify for Medical Assistance (Medicaid). That means they qualify for dual benefits from both agencies. Another fifty percent (50%) of the Medicare population live with one or more chronic condition. The vast majority of these beneficiaries may qualify for one of the three types of Special Needs Plans (SNP) created by the Medicare Modernization Act of 2006:

There are plenty of SNPs available that offer all of the benefits of Original Medicare with added benefits, such as free fitness club memberships, dental benefits, reduced copays and coinsurance, bathroom safety products, as well as additional hearing and vision aids.

How do I select the right SNP Plan?

The importance of coordinated care
When persons with chronic disease are not cared for properly, all too often they are left to navigate the healthcare system on their own. This leads to poorer heath outcomes and disjointed healthcare services. To help tackle this issue, some Medicare SNPs use a care coordinator to help you stay healthy and follow your doctor’s orders. A care coordinator is someone who helps make sure people get the right care and information when they need it.

For example, a Medicare SNP for people with diabetes might use a care coordinator to help members monitor their blood sugar, follow their diet, get proper exercise, schedule preventive services such as eye and foot exams, and get the right prescriptions to prevent complications. A Medicare SNP for people with both Medicare and Medical Assistance might use a care coordinator to help members access community resources and coordinate their different Medicare and Medical Assistance services. Many health plans in this category offer transportation services, which are essential for maintaining optimal health.

Where can I find a SNP plan? Here’s how you can find the Medicare SNP in your area:

The important item to remember is you do have a choice in selecting your health benefits.  Good luck and good health to you in the New Year (2013).


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