What is a Medicare MAPD Special Needs Chronic Condition SNP – C-SNP Plan?
Medicare SNPs Special Needs Plans are a type of Medicare Advantage Plan (like an HMO or PPO). Medicare SNPs limit membership to people with specific diseases or characteristics. Medicare SNPs tailor their benefits, provider choices, and drug formularies to best meet the specific needs of the groups they serve. Medicare.gov
Blue Cross – Care More – Search & details and Enroll ONLINE
email us [email protected] to see if there are SNPs available in your area
Links & Resources
The State Health Insurance Assistance Programs (SHIPs) provide free, in depth, one-on-one insurance counseling and assistance to Medicare beneficiaries, their families, friends, and caregivers.
CA Dept of Aging – HICAP (Local SHIP) – Center for Health Care Rights – 1-800-434-0222
CMS – Medicare – List of conditions for Special Needs Plans
Our unofficial research does not show any other Chronic Mental Health SNP’s in the Los Angeles Area, we checked with Health Net, Blue Shield, AARP – UHC & Goolge. If you know of any, please leave their Internet Address in the comments section below.
What is a Special Needs Plan?
A special needs plan (SNP) is a Medicare Advantage (MA) coordinated care plan (CCP) specifically designed to provide targeted care and limit enrollment to special needs individuals. A special needs individual could be any one of the following:
- An institutionalized individual,
- A dual eligible, or
- An individual with a severe or disabling chronic condition, as specified by CMS.
A SNP may be any type of MA CCP, including either a local or regional preferred provider organization (i.e., LPPO or RPPO) plan, a health maintenance organization (HMO) plan, or an HMO Point-of-Service (HMO-POS) plan. There are three different types of SNPs:
- Chronic Condition SNP (C-SNP)
- Dual Eligible SNP (D-SNP)
- Institutional SNP (I-SNP) cms.govSpecialNeedsPlans *
Can I get my health care from any doctor, other health care provider, or hospital?
You generally must get your care and services from doctors, other health care providers, or hospitals in the plan’s network (except emergency care, out-of-area urgent care, or out-of-area dialysis).
Are prescription drugs covered?
Yes. All SNPs must provide Medicare prescription drug coverage (Part D).
Do I need to choose a primary care doctor?
Do I have to get a referral to see a specialist?
In most cases, yes. Certain services, like yearly screening mammograms, don’t require a referral.
What else do I need to know about this type of plan?
A plan must limit membership to these groups:
1) people who live in certain institutions (like nursing homes) or who require nursing care at home, or
2) people who are eligible for both
Medicare and Medicaid, or
3) people who have specific chronic or disabling conditions (like diabetes, End-Stage Renal Disease, HIV/AIDS, chronic heart failure, or dementia).
Plans may further limit membership.
Plans will coordinate the services and providers you need to help you stay healthy and follow doctors’ or other health care providers’ orders.
Visit Medicare.gov/find-a-plan or check our child pages or
Search, Compare & Try to find plans?
Joppel.com We get a finders fee if you sign up here. We won’t be your agent though.
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