Medicare Advantage Plans for Chronic Conditions
If you’re 65 years old or older and living with a chronic condition, you may be familiar with the term C-SNP. Pronounced “C-snap,” Medicare Advantage special needs health insurance can offer robust coverage and specialized care.
Chronic Condition Special Needs Health Plans
More than 90% of Americans age 65 and older have at least one chronic condition, according to the Centers for Disease Control and Prevention (CDC). Chronic diseases often include diabetes, heart failure or cancer – and many people have more than one chronic condition.
What are C-SNP Medicare Advantage plans?
With Medicare Advantage C-SNP plans, you receive what’s offered in Original Medicare and more. You get Part A (hospital insurance), Part B (medical services and supplies), plus a Medicare Part D prescription drug plan.* These parts all work together under one plan tailored to your specific chronic health needs.
You can also tap into a multidisciplinary group of providers to oversee the management of your chronic condition. Primary care providers, specialists, nurses, dieticians and case workers can integrate care, collaborating to support your overall health.
The goals are to help control risk factors, keep you out of the hospital and improve the overall quality of life.
You can consult a broker who can help weigh your options and educate you about Original Medicare coverage (Parts A and B) and Medicare Advantage plans (Part C), which offer the benefits of Original Medicare and far beyond.
Understanding how Medicare works with your employer coverage can help you avoid penalties, protect your benefits and choose the coverage that fits your needs now and in retirement.
What chronic conditions are covered in C-SNP?
To sign up for a Medicare Advantage C-SNP plan, your doctor must diagnose you with one or more conditions on the Medicare chronic conditions list, which includes:
- Some cancers
- Chronic alcohol use and drug dependence
- Certain autoimmune disorders
- Cancers
- Some cardiovascular disorders
- Dementia and severe mental health conditions
- Type 1 and Type 2 diabetes
- End-stage renal disease requiring dialysis
- HIV/AIDS
- Certain chronic lung disorders
- Neurologic disorders
- Stroke, and more
The list is general and there are exceptions. The full Medicare Chronic Conditions list is available on the Centers for Medicare & Medicaid Services website.
Medicare Advantage C-SNP plans also provide fitness programs, medical supplies, transportation to medical appointments, and coverage for vision, hearing and dental. Most plans offer $0 copays for primary and specialty care services.
Are you eligible for a Medicare Advantage C-SNP plan?
You must have Medicare Parts A and B, and live in the service area of the Medicare Advantage C-SNP plan. Plus, you must have one or more of the conditions on the Medicare chronic conditions list.
It is important to know that your doctor must verify the qualifying chronic condition within 60 days after Medicare Advantage C-SNP plan coverage starts. Otherwise, you can be disenrolled from the plan.
If you currently have a Medicare Advantage plan and received a new diagnosis of a chronic condition on the list, you may qualify for the Medicare Chronic Condition Special Enrollment Period. This special enrollment period allows you to switch plans without fees or penalties.
There are no income limits to qualify and you can have a C-SNP plan even while you’re still working.
Contact Prominence Medicare for help
Call 866-747-8855 to join a health insurance plan during an enrollment period. Our provider network presently offers members access to quality medical services in Florida, Nevada and Texas.
* All benefits not available on all plans
Enroll in a Prominence Health Plan Medicare Advantage plan.
The comprehensive provider network offers members excellent access to quality medical services.
