AHIP Practice Exam

To enroll in a Medicare Advantage Special Needs Plan, an individual must be diagnosed with a specific condition. Special Needs Plans (SNPs) are tailored for individuals with particular health care needs, and they focus on providing specialized services and support. These plans are designed to manage the needs of people with chronic conditions, those living in institutional settings, or individuals who are dual-eligible for Medicare and Medicaid.

The requirement related to a specific diagnosis ensures that the plan is equipped to handle the complexities associated with the health conditions of its members. This allows the enrolled individuals to receive more personalized care and resources that are directly aligned with their unique health circumstances.

The other answer choices involve general Medicare coverage or eligibility concerns that do not directly pertain to the specific requirements for enrollment in Special Needs Plans. For example, having a Part D prescription plan is generally a separate requirement for those on Medicare, but it is not a prerequisite for enrolling in SNPs specifically. Similarly, holding a Medicare supplement plan is unrelated to the eligibility for SNP enrollment, and not being eligible for Medicaid does not apply as a requirement since many SNPs specifically cater to individuals who are dual eligible.