What is a Chronic Special Needs Plan (C-SNP)?
There are a lot of choices to consider when you’re thinking about enrolling in a Medicare plan and what best fits your health and budget needs. But among the options, you may be least familiar with a Chronic Special Needs Plan, or C-SNP. It may be a good option for people with a chronic condition such as diabetes, chronic heart failure, cardiovascular disorders and more.
A C-SNP provides all the coverage of Original Medicare (Part A hospital insurance and Part B medical insurance), Part D prescription drug coverage, and condition care management, and typically has low specialist copays. A C-SNP may also offer extras like dental, hearing and vision benefits.
Depending on your insurer, a C-SNP may provide support for a range of different diseases and conditions, including those who have multiple chronic conditions.
It’s important to check with your insurer or agent to help make sure the C-SNP you’re considering fits your needs.
Who should consider a C-SNP?
About two-thirds of Medicare beneficiaries have multiple chronic conditions.1 These often require coordination of care between providers and specialists, as well as other services. C-SNPs are built to help you manage your condition more effectively by connecting you with providers who specialize in your condition. That may mean fewer gaps in care and better communication between your doctors, which may lead to improved health outcomes.
What are some potential benefits of a C-SNP?
Many C-SNPs may also have benefits such as:
- Monthly credit for
- Over-the-counter (OTC) products which may include everyday supplies like pain relievers, vitamins and more
- Healthy food, which may be extra important if you’re managing a chronic condition
- Low or no-cost transportation to approved locations, such as to medical appointments, which may be valuable for people with limited mobility
- Low or no-cost insulin and diabetic supplies
- Low or no-cost for other drugs that are commonly used to manage certain chronic conditions
Make sure you read any plan documentation carefully, to ensure the benefits match what you’re looking for.
What do I need to enroll in a C-SNP?
After enrollment takes place, a health care provider familiar with your health history will need to verify with the health plan that you have at least one of the chronic conditions required for enrollment. This verification needs to happen within the first 60 days of coverage to stay enrolled. Once your eligible condition has been verified, you will not need a new verification to stay enrolled for future years.
What’s the difference between a C-SNP and D-SNP?
You might have heard about something called a Dual Special Needs Plan, or D-SNP. Although both C-SNPs and D-SNPs go beyond traditional Medicare or a standard Medicare Advantage plan, there are important differences between the two.
A D-SNP is a type of Medicare Advantage plan for people who also qualify for Medicaid, which is called being “dual eligible.” A D-SNP contracts with a state Medicaid program while providing coordination between Medicare and Medicaid.
A C-SNP, on the other hand, is more focused on condition-specific care for people who may not be eligible for Medicaid or do not have a D-SNP available to them. All special needs plans have a focus on care coordination.
If you have a chronic condition, or more than one, a C-SNP may be a great option. Be sure to ask questions as you’re considering what works best for you this Medicare enrollment season.
To learn more about other Medicare topics, visit Medicare.gov
Share
