Middlesex County, Massachusetts Medicare Special Needs Plans

There are 12 Special Needs Plans available in Middlesex County for 2023.   See Plans

4 and 5-Star SNP Plans

Here are the top-rated Medicare Special Needs Plans in Middlesex County.

3.5-Star and Below SNP Plans

These are the SNP plans in Middlesex County rated 3.5 stars or lower by Medicare.

What You Should Know About SNP Plans in Middlesex County

To qualify as a special needs individual you will need to demonstrate one or more of the following criteria:

• You will be institutionalized for 90 or more days,
• You are dual-eligible for both Medicare and Medicaid, or
• You have a severe or disabling chronic condition approved by Medicare.

There are three different types of SNP plans:

When You Can Join a Special Needs Plan

Even if you qualify, you are only allowed to join, drop or change plans during a Medicare Election Period. The period between 15 October and 7 December is the Annual Election Period (AEP). That's when most people in Middlesex County make changes to their Medicare.

1. D-SNP plans are for individuals who qualify for both Medicare and Medicaid (dual-eligible).
2. I-SNP plans are for people who are institutionalized and live in long-term care or skilled nursing facility.
3. C-SNP plans are for people with one or more chronic conditions, including diabetes, end-stage renal disease (ESRD), lung conditions, or heart disease.

All plans are not available in all areas.

You also have an Individual Election Period (IEP). Your IEP begins three months before your 65th birthday, includes your birth month, and continues for three months after your birth month. If you qualify, you can join an SNP during your IEP.

Outside of these periods, you may be able to join a Special Needs Plan with a Special Election Period. Some situations that may qualify you for a Special Election Period include:

If a Special Needs Plan is not a viable option for you, be sure to look at the selection of MA plans in Middlesex County, MA.

• You are diagnosed with a severe or disabling condition: You can enroll in a Chronic-Condition Special Needs Plan (C-SNP) for beneficiaries with your illness at any time.
• You move into a nursing home or require skilled nursing care at home: You can enroll in an Institution Special Needs Plan (I-SNP) or switch plans at any time.
• You qualify for Medicaid: If you have Medicaid or are newly eligible for Medicaid, you can enroll in a Dual-Eligible Medicare Special Needs Plan (D-SNP) at any time.
• You move outside of your existing Special Needs Plan’s service area: You'll qualify for a Special Election Period to switch to a new plan.
• Your Special Needs Plan leaves the Medicare program: You'll qualify for a Special Election Period to switch plans.

Individuals with Medicare that do not qualify for a Medicare SNP are encouraged to compare 2023 Medicare Advantage Plan options in Middlesex County, Massachusetts

The Massachusetts Special Needs Plan information for Middlesex County information on this page originates from Medicare.gov. The All Medicare team last updated and/or refreshed the data on this page on November 12, 2022.