I-SNP Frequently Asked Questions

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I-SNP Eligibility Requirements / Plan Highlights 2025

I-SNP Eligibility Requirements/Plan Highlights 2025

Eligibility Requirements:

You must be enrolled in Medicare Part A and B
Live for at least 90 days in a nursing home contracted with Centers Plan for Nursing Home Care that is located within our New York State service area: Bronx, Erie, Kings, Nassau, New York, Niagara, Queens, Richmond, Rockland, Suffolk, and Westchester Counties.
You are a United States citizen or are lawfully present in the Unites States

I-SNP Materials 2025

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I-SNP Important Member Forms

Important Member Forms

Member Reimbursement Form (last updated 10/2023)

How to Appoint a Representative – Last updated 03/07/19

In the event that you need to appoint a representative regarding a grievance, request a coverage determination or an appeal, or to make complaints, the following form is also available on the Medicare and Medicaid Services (CMS) website below:

CMS1696: Appointment of Representative | CMS

CMS Appointment of Representative Form – Last updated 11/2024

CMS Appointment of Representative Form_Spanish – Last updated 11/2024

CMS Appointment of Representative Form_Large Print – Last updated 11/2024

CMS Appointment of Representative Form Large Print Spanish – Last updated 11/2024

CMS Electronic Complaint Form – Last updated 11/19/2014

Best Available Evidence (BAE) – Last updated 11/19/2014

NYS Standard Form to Designate a Representative