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Prospective Members, Enrolled Members

and Provider Inquiries: 800-405-9681 (TTY 711)

What is a Special Needs Plan (SNP)?

As part of the legislation that established Medicare Advantage Plans, Congress created Special Needs Plans (SNPs) to cover the needs of three specialized groups of patients: 

  • C-SNPs – for those with certain chronic conditions, including cardiovascular disease, diabetes, osteoarthritis, ESRD, HIV/AIDS and mental disorders
  • D-SNPs – for dual eligible (Medicare and Medicaid) patients
  • I-SNPs – for those who are in long-term care institutions for at least 90 days, or who are eligible for institutional care

PPHP is an I-SNP that meets the special needs of residents in long-term care facilities in selected Illinois, Maryland, Missouri, Ohio and Pennsylvania counties. We offer highly coordinated care from skilled, experienced providers, under local leadership. Learn more about the PPHP difference.

Our plan covers care for residents in:

  • Skilled nursing facilities (SNFs)
  • Nursing facilities (NFs)
  • SNFs/NFs
  • Intermediate care facilities (ICFs) – for those who are developmentally disabled in inpatient psychiatric facilities
  • Assisted living facilities (ALFs)

To qualify for PPHP, residents should expect to be in one of these facilities for at least 90 days, or be expected to need at least 90 days of institutional care.

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Page Last Updated:  10/1/2020

Provider Partner Health Plans are HMO-SNPs with Medicare contracts. Enrollment in Provider Partner Health Plans depends on contract renewal. Y0135_PPHPWEB_2021