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Browse Chronic Special Needs plans

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    What is a Chronic Special Needs plan?

     

    A Special Needs plan (SNP) is a Medicare Advantage plan designed to provide targeted care for qualified individuals. A Chronic Special Needs plan (C-SNP) is a Medicare Advantage plan designed for people living with these qualifying chronic conditions:

     

    • Diabetes
    • Chronic heart failure
    • Cardiovascular disorders

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    Is a C-SNP right for you?

     

    It might be right if...

     

    • You have diabetes, chronic heart failure, and/or cardiovascular disorders
    • You would benefit from extra care management programs to support your health
    • You would like added benefits and features at no extra cost, including a monthly credit to pay for OTC products and healthy food

     

    It might not be right if...

     

    • You are eligible for a Dual Special Needs plan (D-SNP) in your area
    • You do not have a qualifying chronic condition (diabetes, chronic heart failure, and/or cardiovascular disorders)
    • You live outside an eligible plan coverage area
    What does a Chronic Special Needs plan cover?

    For people with qualifying chronic conditions, a C-SNP provides all the coverage of Original Medicare (Part A hospital insurance and Part B medical insurance), Part D prescription drug coverage, condition care management and low specialist copays. A C-SNP typically offers many extras like dental, hearing and vision benefits.

    What does a Chronic Special Needs plan cover?

    For people with qualifying chronic conditions, a C-SNP provides all the coverage of Original Medicare (Part A hospital insurance and Part B medical insurance), Part D prescription drug coverage, condition care management and low specialist copays. A C-SNP typically offers many extras like dental, hearing and vision benefits.

    What other Special Needs plans are available?

    Dual Special Needs plans (D-SNPs)

     

    These plans are for people who have both Medicare and Medicaid coverage. They combine Medicare Part A and Part B benefits, plus Medicare Part D prescription drug coverage and support to help coordinate benefits with Medicaid.

    Institutional Special Needs plans (I-SNPs)

     

    These plans are for individuals living in a care facility like a nursing home. An Institutional-Equivalent Special Needs plan (IE-SNP) is for someone who needs the same nursing home level of care, but can live either at home or in a contracted assisted living facility. This is still considered an I-SNP.

    All SNPs include prescription drug coverage. Plan availability will depend on where you live.

     

    What is the difference between a C-SNP and a D-SNP?

    Both plan types provide all the benefits of Original Medicare (Part A and Part B), plus Part D prescription drug coverage. The most important difference is that a C-SNP includes care management for chronic conditions while a D-SNP offers coordination between Medicare and Medicaid to deliver benefits at lower cost to the member.

    Why choose a C-SNP with UnitedHealthcare?

    A UnitedHealthcare C-SNP offers coverage you can count on and expert guidance for whenever you need it. Benefits may include:

    Monthly credit

    Use your UCard® to pay for OTC products and healthy food.1

    Benefits beyond Original Medicare

    $0 copays on dental, vision and hearing exams,

    Diabetic supplies

    $0 diabetic supplies.

    $25 Insulin

    A 1-month supply of covered insulin prescription costs no more than $25.2

    Help to stay healthy

    $0 annual physical exams, $0 lab tests and $0 preventive care.

    Extensive care network

    AAmerica’s largest Medicare Advantage national provider network.3

    Benefit availability and coverage may vary by service area.

    What if there are no C-SNPs where I live?

    If a C-SNP is not available in your area, another Medicare Advantage plan may be a good fit.

    Explore Medicare Advantage plans
    What if there are no C-SNPs where I live?

    If a C-SNP is not available in your area, another Medicare Advantage plan may be a good fit.

    Explore Medicare Advantage plans

    Who is eligible for a Chronic Special Needs plan?

    A C-SNP is intended for someone with a severe or disabling chronic condition. You must be eligible for Medicare Part A and Part B and have a qualifying health condition. You will need to complete a chronic condition verification form with help from your doctor within 60 days of the plan’s start date.

     

    What conditions qualify for a C-SNP?

     

    The Centers for Medicare and Medicaid Services (CMS) allows private insurers to offer C-SNPs for a variety of chronic conditions. UnitedHealthcare C-SNPs are designed for people with diabetes, chronic heart failure or cardiovascular disorders.

     

    When can I enroll in a C-SNP?

    You can enroll during:

     

    • Your Initial Enrollment Period, the 7-month period starting three months before the month of your 65th birthday and ending three months after.
    • The Annual Enrollment Period from October 15 to December 7 each year, when you can switch from Original Medicare to a Medicare Advantage plan, choose a different Medicare Advantage plan, or change your Part D coverage.
    • The General Enrollment Period from January 1 to March 31, when you can sign up for Original Medicare if you did not enroll when you first became eligible. You may then enroll in a Medicare Advantage plan from April through June.
    • The Medicare Advantage Open Enrollment Period from January 1 to March 31, when you can switch from one Medicare Advantage plan to another. You can also drop your Medicare Advantage plan and return to Original Medicare, with or without enrolling in a Part D prescription drug plan.
    •  The Chronic Condition Special Enrollment Period is open any time for people with a severe or disabling chronic condition(s) covered by an available Special Needs plan. This is only allowed for enrolling in a C-SNP, and only if you do not already have a C-SNP serving the same condition.

    How do I enroll in a C-SNP?

     

    To enroll in a UnitedHealthcare C-SNP, you must be eligible for Original Medicare Part A and Part B coverage, live in the plan’s service area, and have your qualifying condition confirmed by a doctor within 60 days of the plan’s start date.

     

    For more information about Special Needs plans, visit Medicare Made Clear®.

     

    Find a Chronic Special Needs plan

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        Benefits, features and/or devices may vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

         

        1 OTC and healthy food benefits have expiration timeframes. Call your plan or review your Evidence of Coverage (EOC) for more information. The healthy food benefit is a special supplemental benefit only available to chronically ill enrollees with a qualifying condition, such as diabetes, chronic heart failure and/or cardiovascular disorders, and who also meet all applicable plan coverage criteria. Contact us for details.

         

        2 You will pay a maximum of $25 for each 1 month supply of Part D covered insulin drug through all drug payment stages except catastrophic drug payment stage where you'll pay $0.

         

        3 Provider network may vary by local market. Provider network size based on ZelisNetwork360, May 2024.

         

        4 The Right Plan Promise® is our commitment to provide you with tools and agent/producer support to help you find a plan in the UnitedHealthcare Medicare plan portfolio that meets your needs. It is not a guarantee that UnitedHealthcare offers a plan that meets the needs of every consumer. Plan recommendations are based on the information that you provide regarding your health coverage needs. Requests to disenroll or change plans remain subject to applicable Medicare regulations and Federal and state laws/regulations.

         

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