Special Needs Plans are a type of Medicare Advantage plan limited to people who meet specific requirements. Because every member shares similar needs, benefits, provider networks and drug formularies are tailored to them.
There are three kinds. Dual Eligible SNPs (D-SNPs) are for people with both Medicare and AHCCCS. Chronic Condition SNPs (C-SNPs) are for people with qualifying conditions such as diabetes or chronic heart failure. Institutional SNPs (I-SNPs) serve people living in a facility.
Most SNPs include a care coordinator who helps schedule appointments, manage medications and connect members with community services. Many D-SNPs in Arizona include generous over-the-counter and healthy food allowances.
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What is included
The coverage you can expect. Exact benefits depend on the plan and the insurance company you choose.
Care coordination
A named coordinator who helps with appointments, transitions home from the hospital and follow-up.
Condition programs
Diabetes supplies, heart failure monitoring and COPD education built into the plan.
Prescription drugs
Part D coverage is required in every SNP.
Healthy food and OTC
Monthly or quarterly allowances for groceries and over-the-counter items on select plans.
Transportation
Rides to medical appointments and the pharmacy on many plans.
Dental, vision and hearing
Often richer than standard Advantage plans for dual-eligible members.
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How we help you choose
Confirm eligibility
We verify your AHCCCS level or qualifying diagnosis with you, privately and respectfully.
Compare coordinated plans
We review networks, allowances and care coordination for the SNPs we offer in your county.
Stay in touch
We help if your Medicaid status changes and review your plan every year.
Why people choose it
Benefits designed around your health needs
Often $0 premiums and low copays
A care coordinator on your side
Extra allowances for food, OTC items and rides
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Costs, and what moves them
Sample figures to help you plan. Your advisor confirms the exact amounts for your age, ZIP code and plan.
Sample costs for Special Needs Plans. Illustrative only, not a quote.
Cost
Sample amount
Good to know
Plan premium
$0 for most D-SNPs
Sample, depends on Medicaid level
Doctor copays
$0 - $20
Varies by plan type
OTC allowance
$75 - $250 / quarter
Sample range, select plans
Drug copays with Extra Help
$0 - $12.65
Per prescription (2026 sample)
Factors that change your price
Your AHCCCS or Medicare Savings Program level
Documentation of a qualifying chronic condition
Whether your doctors participate in the SNP network
Where you live in Pima or Cochise County
Figures are illustrative samples and not a quote. Medicare amounts change every January.
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Special Needs Plans questions we hear
You need Medicare Parts A and B and active AHCCCS coverage or a Medicare Savings Program. Send us your AHCCCS letter or call and we will check with you.
Diabetes is one of the qualifying conditions for chronic condition plans. The plan will verify the diagnosis with your doctor after you apply.
People with Medicaid or Extra Help have a monthly Special Enrollment Period to switch into certain plans, and a new qualifying diagnosis can also open a window.
