special needs individual
(B)The term “special needs individual” means an MA eligible individual who— (i)is institutionalized (as defined by the Secretary); (ii)is entitled to medical assistance under a State plan under subchapter XIX; or (iii)meets such requirements as the Secretary may determine would benefit from enrollment in such a specialized MA plan described in subparagraph (A) for individuals with severe or disabling chronic conditions who— (I)before, have one or more comorbid and medically complex chronic conditions that are substantially disabling or life threatening, have a high risk of hospitalization or other significant adverse health outcomes, and require specialized delivery systems across domains of care; and (II)on or after, have one or more comorbid and medically complex chronic conditions that is life threatening or significantly limits overall health or function, have a high risk of hospitalization or other adverse health outcomes, and require intensive care coordination and that is listed under subsection (f)(9)(A). (c)