Eligibility - Medicare Special Needs plans
To enroll in a Special Needs plan you must have Original Medicare Part A (hospital) and Part B (medical), live in the plan's service area, and meet the plan's specific eligibility requirements, such as one of the following:
- Have both Medicare and Medicaid* (also called "dual eligible")
- Live in a contracted skilled nursing facility (SNF)
- Live in a contracted assisted living facility and need the same kind of care as people who live in a SNF
- Have diabetes, chronic heart failure and/or certain cardiovascular disorders
*Dual eligible enrollees are either Full Dual Eligible or Partial Dual Eligible. Full Dual Eligible enrollees qualify for full state Medicaid benefits, including covered medical care. Partial Dual Eligible enrollees don't qualify for medical benefits through their state Medicaid program, but may qualify for additional help. Check eligibility requirements before you start the enrollment process. Some Dual Special Needs Plans (D-SNPs) only accept members who are Full Dual Eligible.