For insurers that remain committed to their Medicare Advantage businesses, special needs plans have been a major growth driver. KFF estimated that almost half of MA enrollment growth from 2024 to 2025 stemmed from these tailored plans. In 2025, SNPs covered 21% of MA enrollees.
Chronic condition, dual-eligible and institutional SNPs address members who have specific long-lasting health issues, also qualify for Medicaid or require an institutional level of care (through a long-term facility or at home), respectively. Every SNP must follow a CMS model of care framework approved by the National Committee for Quality Assurance.
Becker’s heard from two insurers and one SNP partner to better understand the value of these plans — and how to do them right.
“I think SNP growth is really happening because Medicare Advantage is becoming more clinically precise in many ways,” Matt Eyles, Alignment Health’s executive vice president of government and business strategy. “If you’re able to target specific medical conditions and build support around them, then you can achieve better outcomes for seniors and hopefully keep them in the home rather than in institutional or other higher cost settings.”
Policy landscape and challenges
Some payers do not opt to participate in I-SNPs as they are less targeted toward that level of care. Others are fixed on it: SCAN Health Plan’s I-SNP saw record enrollment in 2026, according to the company.
D-SNPs, which have historically achieved greater enrollment than C-SNPs, also face their own challenges as states roll out policies encouraging full integration. In simple terms, an insurer may need to support both Medicaid and Medicare in order to house a D-SNP.
Belong Health assists regional health plans with launching MA plans and SNPs. Co-founder and CEO J. Patrick Foley said the state-by-state variability with D-SNPs has primed carriers specifically for C-SNPs — and many are leaning in.
“It’ll be interesting to see if, as the Medicaid disruption starts to settle out, if maybe it swings back more in the direction of dual special needs,” Mr. Foley said. “But definitely, right now, there’s been a real spike in chronic special needs plans.”
He referenced shifting Medicaid eligibility redeterminations as one point of disruption.
C-SNPs, in particular, also offer more predictability. Since members already come in with a qualifying condition, payments can reflect acuity sooner than regular MA plans, Mr. Foley said.
Growth discipline
While some plans, mostly regional, have been boasting strong MA enrollment overall, high enrollment numbers do not equate to success with SNPs. Mr. Foley said a more geographically concentrated membership base can help as plans establish clinical partnerships, particularly with primary care providers. He also cautioned against using SNPs to drive membership.
“It has the potential to cause disruptions down the road in terms of not necessarily having the right care model infrastructure in place, or the right physician relationships in place, to manage the population,” he said.
UnitedHealthcare is the largest player in the SNP space. Betsy Chin, senior vice president of Medicare Advantage, said UnitedHealthcare’s biggest cost drivers are “medical complexity, social needs and care coordination requirements.”
“Sustainability is strongest where benefits, providers and care management are aligned, and where we can work closely with state partners and community resources to deliver meaningful value to the people we serve,” she said.
In terms of expansion, UnitedHealthcare has no state updates or timelines to share right now, but Ms. Chin said expansion is strategized market by market, and takes into consideration partnerships and local needs. The company is currently evaluating further opportunities for SNP growth.
Another factor as plans hope to grow: Since these members are more complex, carriers need to maintain high engagement. Mr. Eyles said Alignment connects with C-SNP members an average of 24 times per year, making it “a very high-touch model.”
Competition and the future of SNPs
Competition is heating up. As Mr. Foley sees heightened interest in C-SNPs, Mr. Eyles said he has also witnessed new entrants, as well as big investments from national plans. Ms. Chin has spotted greater participation from regional insurers, Medicaid-focused organizations and provider-aligned models. She said SNPs are “a growing share” of UnitedHealthcare’s Medicare Advantage portfolio, and there are “opportunities for thoughtful growth” across C-, D- and I-SNPs.
“Ultimately, success depends less on who enters the market and more on who can deliver integrated, high-quality care,” Ms. Chin said.
Mr. Foley and Ms. Chin both said plans are striving for “balance” with their product portfolios, embracing general MA and several SNPs.
“We believe Medicare Advantage must continue to include a mix of plan types, but SNPs will play an increasingly important role as the population ages and needs become more complex,” Ms. Chin said. “Plans designed around specific needs are better positioned to deliver value for members and the system overall.”
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