What Is Special Needs Coverage?

No one likes to think about the unthinkable—that’s why we call it the unthinkable, right? But truth be told, you’ve got to be prepared. And when it comes to things like special needs plans and child rider life insurance coverage, it’s really easy to blow it off because it’s super uncomfortable to talk about. But it’s time to lean in (you can do this!). Let’s talk about topics no one is going to bring up at a dinner party . . .

What Is Special Needs Coverage? 

This kind of specialized coverage offers specific health insurance for people who have disabling or chronic conditions, are in an care facility, or are eligible for both Medicare and Medicaid coverage (more on that later).¹

What Do Medicare Special Needs Plans (SNPs) Cover? 

If you have a chronic illness, Medicare Special Needs Plans (SNPs) will cover the same things that Medicare Advantage Plans cover.² That includes routine health care visits for hearing, vision and dental, plus things like prescriptions, emergency needs, hospice care and transportation to and from doctor visits.³ Medicare SNPs will even cover extra days spent in the hospital too. Each plan is a little different, so do your research when you’re weighing your options here. 

What Are Dual Special Needs Plans? 

If you opt in for the Dual Eligible Special Needs Plans (D-SNPs) then this will include both Medicaid and Medicare coverage for you.⁴ What’s Medicaid and Medicare? We’re so glad you asked. Here’s a quick rundown of what those terms actually mean:

Medicaid 

Medicaid gives aid (just like it sounds) to people with disabilities, pregnant women, children, families with lower incomes, and the elderly. Medicaid helps out with your monthly health insurance premiums and other costs like co-payments, deductibles and out-of-pocket bills.⁵ Basically, Medicaid helps you out if you have a low income or a family to support. 

Medicare 

Medicare’s job is to provide hospital and medical care for more at-risk groups. This would cover people over the age of 65 and anyone under 65 who has gotten Social Security disability benefits for more than two years.⁶

What Is Child Rider Coverage? 

It might sound like a new car seat brand or hip slang for your minivan—but a child rider is basically just life insurance for children. And it’s usually a guaranteed issue, meaning they don’t do a medical exam or they’re not going to worry about any type of special needs or chronic issues here.

Having child rider coverage will cover you in the unlikely event that (God forbid) you have to pay funeral expenses for a child. It’s a horrible thought that no one ever wants to imagine, so don’t worry—we’re almost done talking about it.

Do I Need a Child Rider if I Have an Emergency Fund? 

Nope. When you’ve built up enough of an emergency fund that you could cover an unspeakable expense like that, then you won’t need a child rider on your insurance plan anymore. You would be able to pay for it out of pocket by using your emergency fund. But if you’re still working on saving up your emergency fund, then yes, having a child rider as part of your term life insurance would be a good bet to tide you over in the meantime. 

Have more questions? Of course you do—it’s insurance and it’s dang confusing when you don’t live in that headspace all day. So, have a look at a few next steps you can take right now to get clarity on the kind of coverage you need.