US · guidance
CMS Pub. 100-16, ch. 1, § 20.2.3
Special Needs Plans (SNPs)
A SNP may be offered as any of the CCP types and must satisfy CMS' SNP
requirements. SNPs must exclusively enroll special needs individuals as appropriate to
the SNP type (42 CFR 422.4(a)(1)(iv)).
The MMA designated three specific segments of the Medicare population as special
needs individuals: (1) institutionalized individuals; (2) those entitled to Medical
Assistance under a State Plan under Title XIX (Medicaid) (i.e., dual eligibles); or (3)
those who have “a severe or disabling chronic condition” who would “benefit from
enrollment in a specialized MA plan (Section 1859 of the Act and 42 CFR 422.2).
Corresponding to these segments of the Medicare population there are three types of
SNPS: I-SNPs for institutionalized individuals, D-SNPs for dual eligible individuals and
C-SNPs for chronic-condition individuals.
See chapter 16b for more details on these requirements.
History
(Rev. 124, Issued: 11-10-16; Effective: 11-10-16; Implementation: 11-10-16)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
152963b6d9c8215c3c92ba216c18538da2502e1677f31b4bb55b00172164a36a
The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.
Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.