Chronic Special Needs Plans

Chronic Special Needs Plans

Chronic Special Needs Plans (C-SNPs) provide comprehensive medical treatment coverage to those suffering from a qualifying condition. They are incredibly inexpensive and effective at providing you with individualized care and benefits.

But, before counting on a C-SNP, you have to know more about it. Here’s a closer look at this Advantage plan and whether or not it’s right for you.

Qualifying for a C-SNP

The most important thing you need to understand about C-SNPs is their qualifications. In order to be eligible for a C-SNP, you must have one of the approved conditions. Generally, these illness 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; and
  • Group 5:  Stroke and cardiovascular disorders.

If you feel you may fit into any of these groups, here is the list of specific qualifying conditions from the Centers for Medicare & Medicaid Services:

  • Chronic alcohol and other drug dependence
  • Autoimmune disorders limited to:
    • Polyarteritis nodosa
    • Polymyalgia rheumatica
    • Polymyositis
    • Rheumatoid arthritis
    • Systemic lupus erythematosus
  • Cancer
  • Cardiovascular disorders limited to:
    • Cardiac arrhythmias
    • Coronary artery disease
    • Peripheral vascular disease
    • 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
    • Sickle-cell disease (excluding sickle-cell trait)
  • HIV/AIDS
  • Chronic lung disorders limited to:
    • Asthma
    • Chronic bronchitis
    • Emphysema
    • Pulmonary fibrosis
    • Pulmonary hypertension
  • Chronic and disabling mental health conditions limited to:
    • Bipolar disorders
    • Major depressive disorders
    • Paranoid disorder
    • Schizophrenia
    • Schizoaffective disorder
  • Stroke
  • Neurologic disorders limited to:
    • Amyotrophic lateral sclerosis (ALS)
    • Epilepsy
    • Extensive paralysis (i.e., hemiplegia, quadriplegia, paraplegia, monoplegia)
    • Huntington’s disease
    • Multiple sclerosis
    • Parkinson’s disease
    • Polyneuropathy
    • Spinal stenosis
    • Stroke-related neurologic deficit

C-SNP Coverage

The coverage you receive through a C-SNP plan will be tailored to your specific condition and healthcare needs. Benefits are typically based on the group you fit into (1 of 5 options). And, if you have an urgent need for something not listed in your plan, you may be able to get coverage for it upon approval.

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Get the Medicare Coverage You Need

Finding coverage for a chronic condition isn’t easy. You have to make sure that all of your treatments, hospital visits, etc. are all covered because the last thing you want is to miss out on something you really need.

If you think you may qualify for a C-SNP plan, or have questions about Medicare in general, I’m local in Lithia and here for you.

Help is only a phone call away—contact MB Insurance Solutions today at 813-767-2878.