Two-thirds of seniors enrolled in traditional Medicare plans have chronic conditions requiring coordination among primary care doctors, medical and mental health specialists, and inpatient and outpatient facilities, as well as diagnostic testing, multiple medications, and therapeutic management services.
“If you are living with a severe or disabling chronic condition, such as cardiovascular disease, diabetes, or congestive heart failure, having access to the right doctors, treatments, and support is vital to maintain not only physical function but also energy, mood, and overall quality of life,” says Teresa Lara, Medicare Sales Manager at Zing Health.
If you are a Medicare beneficiary and have a chronic condition, it’s a good idea to consider a Medicare Advantage Chronic Condition Special Needs Plan (C-SNP) tailored to your specific condition or conditions. C-SNP plans typically cost little to nothing more than original Medicare and include customized care plans with resources to not just improve your health, but make life easier.
What Is a Medicare Advantage Special Needs Plan?
A Special Needs Plan offers services beyond the basic Medicare Part A and B coverage. For example, C-SNPs for people with diabetes include education and resources, plus savings on diabetic supplies and insulin, coordinated by a care team that supports each member’s needs.
“C-SNP plans aim to help Medicare patients with severe or disabling chronic conditions avoid hospitalization or other serious complications,” says Ms. Lara. “Many people with these conditions are not aware that specialized plans like this exist.”
To enroll into a C-SNP plan, you need to have Medicare Part A and B coverage and live in the plan’s service area. Your doctor must verify you have one of the conditions that the plan is designed to cover.
The usual Medicare Advantage enrollment period is Oct. 15 through Dec. 7; however, if you have your chronic condition verified and meet any other criteria the plan requires, you have the opportunity to enroll in a C-SNP plan outside of the annual enrollment period.
What Does a Chronic Condition Special Needs Plan Cover?
C-SNP plans combine into a single plan:
- Medicare Part D coverage for prescription medicine, with a formulary tailored to cover medications for the chronic conditions the plan is focused on
- Medicare Part A coverage for hospital services
- Medicare Part B coverage doctor visits, testing, and treatment services
- Plus extra benefits such as dental, vision, and hearing care, which are vital to people with chronic conditions
C-SNP plans also provide a higher level of care management for your condition, including a dedicated care team who checks in on you regularly. For example, they make sure that you understand and are taking your medication, that you have transportation to doctor visits, that there’s healthy food available in your area, and that depression isn’t settling in.
“We recommend anyone who is eligible for Medicare and has been diagnosed with diabetes, cardiovascular disease, or congestive heart failure consider enrolling in a C-SNP plan,” says Ms. Lara. “For little to no extra cost, you get all the same benefits as the other Medicare Advantage plans your carrier offers, plus so much more, tailored specifically to you.”