The three kinds of special needs plans
| Type | Who can join | Ohio notes |
|---|---|---|
| D-SNP (dual eligible) | People with both Medicare and Ohio Medicaid, including people who get only Medicare Savings Program help, depending on the plan | For 2027, only plans tied to MyCare Ohio. See below. |
| C-SNP (chronic condition) | People with certain severe or disabling chronic conditions, such as diabetes, chronic heart failure, chronic lung disorders, dementia or end-stage renal disease | Offered by county; check what's sold in yours. |
| I-SNP (institutional) | People who live, or are expected to live, 90 days or more in a nursing home or similar facility, or who need that level of care at home | Often limited to residents of specific facilities. |
For 2027, CMS lists 46 special needs plans in Ohio, with 33 in Cuyahoga County, 24 in Franklin County and 19 in Scioto County. Every county has some.
D-SNPs and MyCare Ohio
Next Generation MyCare Ohio has covered all 88 counties since August 1, 2026. It serves people 21 and older with Medicare Parts A, B and D and full Ohio Medicaid. The Medicaid side is required: you're enrolled in a MyCare plan for Medicaid. The Medicare side is your choice.
- Full Medicaid: if you also choose your MyCare plan's D-SNP for Medicare, one plan covers both, and Ohio requires that D-SNP to be fully integrated (a FIDE SNP).
- Medicare Savings Program only: MyCare organizations may offer a separate coordination-only D-SNP for people who get only premium help.
- Other D-SNPs: D-SNPs from other companies don't continue for 2027. If yours ended, see Ohio plans ending in 2027.
To choose or change a MyCare plan, call the Ohio Medicaid Consumer Hotline at 1-800-324-8680. More is on MyCare Ohio and dual eligible special needs plans in Ohio.
When you can join or switch
If you have Medicaid or Extra Help, Medicare lets you change your drug coverage once a calendar month, including dropping a Medicare Advantage plan for Original Medicare with a standalone drug plan. With full Medicaid, you can also join an integrated D-SNP such as a MyCare plan once a month. Changes start the first of the next month. For C-SNPs and I-SNPs, special enrollment periods apply when you're diagnosed with a qualifying condition or move into or out of a facility.
To compare plans from the companies they work with, you can request a call from a licensed insurance agent.
Related questions
Can I be turned down?
What plans can and can't check.
How many plans are in Ohio?
2027 counts from CMS.
How do I choose a plan?
Five steps to compare.
Sources
- Medicare.gov — Special Needs Plans (SNP)
- Medicare.gov — Understanding Medicare Advantage Plans (SNP types and qualifying conditions)
- Medicare.gov — Special Enrollment Periods (Medicaid, Extra Help, integrated D-SNPs)
- Ohio Department of Medicaid — Next Generation MyCare Member Frequently Asked Questions
- Ohio Administrative Code 5160-58-02, MyCare Ohio eligibility
- CMS — Medicare Advantage and Part D Landscape files, contract year 2027 (special needs plan counts)
More questions in this guide
- Can I be turned down for a Medicare Advantage plan in Ohio?
- How do I choose a Medicare plan in Ohio?
- How many Medicare Advantage plans are available in Ohio for 2027?
- Is Medicare Advantage available in every Ohio county?
Part of the guide: Medicare Advantage in Ohio · All questions
Frequently asked questions
My D-SNP from another company ended for 2027. What now?
For 2027 every Ohio D-SNP belongs to one of the organizations running MyCare Ohio, so D-SNPs from other companies did not continue. If yours ended, you have a special enrollment period to choose new coverage; with full Medicaid you can also change plans once a month. Call the Ohio Medicaid Consumer Hotline at 1-800-324-8680 or 1-800-MEDICARE.
Do I have to join a MyCare plan for my Medicare?
No. If you qualify for MyCare Ohio, your Medicaid benefits come through a MyCare plan, but for Medicare you choose: the same plan's D-SNP, so one plan covers both, or Original Medicare or another Medicare plan.
How do I prove I qualify for a chronic condition plan?
The plan must confirm the condition with your doctor, physician assistant or nurse practitioner, either before you enroll or, if it uses a pre-enrollment assessment, by the end of your first month in the plan (42 CFR 422.52(f)).
Medicare in your Ohio county
Plans, local agents and help, county by county: Franklin · Cuyahoga · Hamilton · Summit · Montgomery · Lucas · Butler · Stark · Lorain · Warren · Delaware · Lake · Mahoning · Clermont · Trumbull · Licking · Medina · Greene · Fairfield · Portage · All 88 counties →
