To learn what can qualify you for a Chronic Special Needs plan, continue reading.
Special Needs Plans provide benefits and services to people with certain health care needs or limited incomes. They have benefits, provider options, and formularies that are designed to meet the specific needs of the groups that qualify. These plans cover the same benefits that all Medicare Advantage Plans cover, primarily Part A hospital insurance and Part B medical insurance. Though, many SNPs have additional benefits included to cover extra services that members often need. For example, if a plan is designed for people who have a severe condition that often requires a hospital stay, an SNP could cover extra days in the hospital.
There are several ways to qualify for a Special Needs Plan. You may qualify due to a specific disease, unique health care needs, or limited income. If you qualify due to a chronic condition, you can join a Chronic Special Needs Plan (C-SNP). The chronic conditions that can qualify you for an SNP include:
If you are enrolled in a Chronic Special Needs Plan, you generally must seek care from doctors and other health care providers that are within the plan’s network.
SNP plans may require you to have a primary care doctor to coordinate your care, but this varies across plans. If you have a chronic condition, having a primary care doctor can make managing your condition much easier. Therefore, some plans require you to maintain a primary care provider.
Another important note is that all SNPs must provide Medicare prescription drug coverage. This means you won’t have to worry about finding other drug coverage.