What benefits are included in a Chronic Condition Special Needs Plan? 

All C-SNPs must cover every benefit included in Original Medicare Parts A and B, but they must also include a greater range of benefits and health care services that are geared for people with chronic conditions that aren’t available through traditional Medicare. 

C-SNPs must also provide:

• Personal care management services customized to support the medical needs of enrollees with chronic conditions. Services include health care coordination, disease management, and management of prescription drugs and other medications 
• Extra benefits such as dental, vision, and hearing care services. 
• Prescription drug coverage including all medications that help the enrollees manage their chronic conditions 
• Cost-saving conditions such as lower copayments, coinsurance, and deductibles 

How much does a Chronic Condition Special Needs Plan cost? 

How much you pay for coverage under a C-SNP may vary depending on where you live, what type of coverage you choose (such as an HMO or PPO), and the specific plan you enroll in. 

Typically, you’ll pay the Original Medicare Part B monthly premium and an additional premium for the C-SNP. Today in the U.S., approximately 64 percent of available C-SNPs have $0 monthly premiums, and the others average around $24.50 per month. 

Depending on the type of Chronic Condition Special Needs Plan you enroll in, you may be required to use plan-approved network providers to receive coverage, and if you go outside the network (except in the case of emergency care) health care services won’t be covered.

When can you enroll in a Chronic Condition Special Needs Plan? 

If you meet all the eligibility requirements for a C-SNP, you can enroll at any time during the year. 

You can keep your C-SNP coverage for as long as you meet the eligibility requirements. If your medical situation changes and you don’t meet these requirements any longer, you’ll be immediately eligible for a Medicare Special Enrollment Period (SEP). During your SEP you can switch to a different Medicare Advantage (Part C) plan or return to Original Medicare Part A and/or Part B (and enroll in a Prescription Drug Plan).