Chronic Special Needs Plans

Chronic Special Needs Plans

Chronic Special Needs Plans (C-SNPs) cover a variety of life-threatening illnesses. If you qualify, you will receive individualized benefits at a very low cost.

There is an incredibly long list of qualifying conditions. According to the Centers for Medicare & Medicaid Services, this is the full list of illnesses.

Full List of
C-SNP Qualifying
Conditions

  • Chronic alcohol and other drug dependence
  • Autoimmune disorders (limited to Polyarteritis nodosa, Polymyalgia rheumatica, Polymyositis, Rheumatoid arthritis, and Systemic lupus erythematosus)
  • Cancer
  • Cardiovascular disorders (limited to Cardiac arrhythmias, Coronary artery disease, Peripheral vascular disease, and Chronic venous thromboembolic disorder)
  • Chronic heart failure
  • Dementia
  • Diabetes mellitus
  • End-stage liver disease
  • End-stage renal disease (ESRD)
  • Severe hematologic disorders (limited to Aplastic anemia, Hemophilia, Immune thrombocytopenic purpura, Myelodysplastic syndrome, and Sickle-cell disease)
  • HIV/AIDS
  • Chronic lung disorders (limited to Asthma, Chronic bronchitis, Emphysema, Pulmonary fibrosis, and Pulmonary hypertension)
  • Chronic and disabling mental health conditions (limited to Bipolar disorders, Major depressive disorders, Paranoid disorder, Schizophrenia, and Schizoaffective disorder)
  • Stroke
  • Neurologic disorders (limited to Amyotrophic lateral sclerosis (ALS), Epilepsy, Extensive paralysis, Huntington’s disease, Multiple sclerosis, Parkinson’s disease, Polyneuropathy, Spinal stenosis, and Stroke-related neurologic deficit)

Receiving
C-SNP Benefits

If you currently have any of these conditions, you will almost certainly qualify for a C-SNP. The benefits you receive through your plan will be catered towards your specific healthcare needs. Generally, conditions are grouped into 5 categories:

  • Group 1: Diabetes mellitus and chronic heart failure
  • Group 2: Chronic heart failure and cardiovascular disorders
  • Group 3: Diabetes mellitus and cardiovascular disorders
  • Group 4: Diabetes mellitus, chronic heart failure, and cardiovascular disorders
  • Group 5: Stroke and cardiovascular disorders

 

When enrolling in a C-SNP, your benefits will fall into one of these groups, thus matching your specific needs. And, if for some reason you need healthcare outside of the plan’s provided benefits, you may receive coverage upon approval.

The Cost
of a C-SNP

More often than not, you will pay next to nothing for a C-SNP. This means no premiums, deductibles, copayments, or coinsurance. And, prescription drug coverage will likely be included as well.

There are really no drawbacks to a C-SNP. If you qualify, you should consider enrolling in one as soon as possible to save you the headache of costly medical bills.

Confusing
C-SNP with D-SNP

Though the two sound very similar, it is important that you do not mix up Chronic Special Needs Plans (C-SNP) and Dual-Eligible Special Needs Plans (D-SNP).

Unlike C-SNPs, D-SNPs are targeted towards those in financial need. You must, then, be “dually-eligible” for both Medicare and Medicaid.

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