A Special Needs Plan is a category of Medicare Advantage plan designed to attract and enroll Medicare beneficiaries who fall into a certain special needs demographic. There are two types of SNPs. The exclusive SNP enrolls only those beneficiaries who fall into the special needs demographic. The other type is the disproportionate share SNP. “Disproportionate share” SNPs enroll a greater percentage of the target special needs population as compared to a national percentage of the target population. Under the Medicare Prescription Drug, Improvement, and Modernization Act

Medicare Prescription Drug, Improvement, and Modernization Act

The Medicare Prescription Drug, Improvement, and Modernization Act is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health program's 38-year history.The MMA was signed by President George W...

 of 2003, Congress identified special needs individuals” as (1) institutionalized, or (2) dually eligible, or (3) individuals with severe or disabling chronic conditions. More specifically, special needs individuals include:

Institutionalized Beneficiaries, defined as those who reside or are expected to reside for 90 days or longer in a long term care facility (defined as either: skilled nursing facility (SNF)/NF, ICF or inpatient psychiatric facility), or those living in the community but requiring an equivalent level of care to those residing in a long term care facility.

Dually Eligible Beneficiaries, definied as individuals who are entitled to Medicare Part A and/or Part B and are eligible for some form of Medicaid

Medicaid

Medicaid is the United States health program for certain people and families with low incomes and resources. It is a means-tested program that is jointly funded by the state and federal governments, and is managed by the states. People served by Medicaid are U.S. citizens or legal permanent...

 benefit.

Beneficiaries with Chronic Conditions, defined as individuals who have acquired one or more disabling chronic conditions, including, but not limited to: cardiovascular disease

Cardiovascular disease

Heart disease or cardiovascular disease are the class of diseases that involve the heart or blood vessels . While the term technically refers to any disease that affects the cardiovascular system , it is usually used to refer to those related to atherosclerosis...

, diabetes, congestive heart failure

Congestive heart failure

Heart failure often called congestive heart failure is generally defined as the inability of the heart to supply sufficient blood flow to meet the needs of the body. Heart failure can cause a number of symptoms including shortness of breath, leg swelling, and exercise intolerance. The condition...

, osteoarthritis

Osteoarthritis

Osteoarthritis also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion...

, mental disorders, ESRD, and HIV

HIV

Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

/AIDS

AIDS

Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

.