Who it's for
- People with Medicare Parts A and B who have diabetes
- People diagnosed with chronic heart failure or certain cardiovascular conditions
- Anyone who wants care coordination built around a chronic condition
- People who live in the plan's service area
What it covers
- All the hospital and medical benefits of Original Medicare
- Prescription drug coverage, which every Special Needs Plan includes
- Doctor networks and drug lists designed around your condition
- Enhanced benefits that vary by plan, such as care coordination or extra supplemental benefits
What is a Chronic Condition Special Needs Plan?
Special Needs Plans (SNPs) are Medicare Advantage plans limited to people with specific needs. A Chronic Condition SNP (C-SNP) is for people living with certain severe or disabling chronic conditions. Because everyone in the plan shares a similar health picture, the plan can tailor its doctors, drug list and care programs to that condition.
Common qualifying conditions include diabetes, chronic heart failure and cardiovascular disorders. The exact conditions depend on the plan, and the plan confirms your diagnosis with your doctor as part of enrollment.
Benefits you may qualify for
Benefits vary from plan to plan and year to year, so we review the specific plans available where you live. Depending on the plan, a C-SNP may include:
- A care coordinator or care team to help manage appointments and medications
- Lower copays for doctors and specialists who treat your condition
- Reduced costs for some medicines and supplies related to your condition
- Extra supplemental benefits, such as allowances for healthy food or over-the-counter items, for members who qualify
When you can join
You can join a C-SNP during the regular enrollment periods, such as the Annual Enrollment Period. If you have a qualifying chronic condition, you also have a Special Enrollment Period that lets you join a C-SNP designed for your condition at other times of the year. Coverage continues only while you meet the plan's eligibility rules, so we'll explain what happens if your situation changes.
Diagnosed recently?
If you've been diagnosed with a chronic heart condition or diabetes, call us. You may qualify for a plan with enhanced benefits — and you may not have to wait until fall to make a change.
Other types of Special Needs Plans
There are two other kinds of SNPs. Dual Eligible SNPs (D-SNPs) are for people who have both Medicare and Medicaid. Institutional SNPs (I-SNPs) are for people who live in a nursing home or need that level of care at home. If either might apply to you or a family member, we'll talk through the options.
How we help
We'll ask about your diagnosis and medicines, check which C-SNPs serve your parish, confirm your doctors are in network, and compare the costs with a regular Medicare Advantage plan. If a C-SNP isn't the best fit for you, we'll say so.
Common questions about Special Needs Plans
How do I prove I have a qualifying condition?
The plan verifies your condition with your doctor, usually soon after you apply. We'll explain the steps and what information the plan will need.
Is a C-SNP more expensive?
Not necessarily. Many C-SNPs have premiums and copays similar to other Medicare Advantage plans, and some offer lower costs for condition-related care. We'll compare the details with you.
Can I keep my cardiologist or endocrinologist?
It depends on the plan's network. We check your specialists before you enroll.
What if I have both diabetes and heart disease?
Some plans are designed for people with more than one related condition. We'll look for the plan that fits your full health picture.
