Chronic Special Needs Plans (C-SNPs) provide full-coverage benefits to those with qualifying severe or disabling chronic conditions. Generally, you can expect all C-SNPs to offer at least the typical Medicare coverage, including benefits such as hospital care and prescription drugs.
You can also expect many additional benefits to address your qualifying condition. In most cases, your plan will customize said benefits, networks, and drug formularies to better meet the beneficiary’s specific needs.
The coverage you receive under a C-SNP will, then, likely vary depending on your circumstances. The most important thing to look at when investigating these plans, then, is to see whether or not you qualify and how to enroll if you do.
Qualifying for a C-SNP
Most severe or disabling chronic conditions will qualify you for a C-SNP. There are, in general, 5 different broad categories of enrollment you must fall under:
- Group 1: Diabetes mellitus & chronic heart failure;
- Group 2: Chronic heart failure & cardiovascular disorders;
- Group 3: Diabetes mellitus & cardiovascular disorders;
- Group 4: Diabetes mellitus, chronic heart failure, & cardiovascular disorders; &
- Group 5: Stroke & cardiovascular disorders.
Not sure whether your condition falls under one of these groups? Here are some specific qualifying conditions:
- Chronic alcohol and other drug dependence
- Autoimmune disorders*
- Cancer
- Cardiovascular disorders*
- Chronic heart failure
- Dementia
- Diabetes mellitus
- End-stage liver disease
- End-stage renal disease (ESRD)
- Severe hematologic*
- HIV/AIDS
- Chronic lung disorder*
- Chronic and disabling mental health conditions*
- Neurologic disorders*
- Stroke
*Please note that these categories have certain limitations on what conditions qualify under them. For example, neurological disorders can include epilepsy and Huntington’s disease, but not Alzheimer’s or certain other conditions. For the most part, however, almost all chronic conditions will qualify, even with these limits.
Why You Want a C-SNP
Chronic conditions are serious and hard to treat, especially if paying out of pocket. A basic Medicare plan may not cover the treatments and prescriptions you need for your specific circumstances.
C-SNPs customize your coverage and benefits based on your needs. That way, you will rarely have to worry about whether a treatment or prescription is included in your plan.
According to the U.S. National Library of Medicine, “chronic diseases are among the most prevalent and costly health conditions in the United States. Nearly half (approximately 45%, or 133 million) of all Americans suffer from at least one chronic disease, and the number is growing.”
If you have a qualifying chronic condition, it may be well worth it to consider a C-SNP.
Get the Medicare Plan You Need with Meservey & Associates
Unsure if you qualify for a Medicare C-SNP? We can help. Our talented agents will take the time to understand your circumstances to get you the coverage you need, even if you don’t qualify for a C-SNP.
In your time of need, we’re here for you. For free Medicare advice, call Meservey & Associates at 478-254-4209.
