A C-SNP is a type of Special Needs Plan (SNP) designed for people who need some extra support due to a chronic or disabling condition. C-SNPs are available through private insurance companies that Medicare approves—like Humana. They include all the benefits of Original Medicare Part A (hospital coverage) and Part B (medical coverage). In addition, all C-SNPs are required to provide prescription drug coverage, called Medicare Part D, and most include coverage for routine dental, vision and hearing care.
To enroll in a C-SNP, you must be eligible for Medicare Part A and Part B and your healthcare provider must verify your qualifying condition.
C-SNPs are designed to address the challenges of dealing with chronic or disabling conditions. Here are just a few examples of qualifying conditions:
- Autoimmune disorders
- Cancer
- Diabetes
- End-stage kidney disease
- HIV/AIDS
- Chronic Heart Failure
- Chronic lung disease
- Dementia
All C-SNPs must cover prescription drugs. Some plans feature $0 Rx copays for drugs on the plan’s formulary (list of covered drugs). Most also include coverage for routine dental, vision and hearing care—all in 1 easy-to-manage plan.
Some C-SNPs also offer a Medicare Part B giveback, and some include the Humana Healthy Options allowance. For qualified members, this allowance can be used to pay for eligible healthy food, over-the-counter (OTC) items, utilities, rent assistance, household supplies, living expenses, pet supplies and more.
C-SNPs may assign a care coordinator to work directly with a plan member. Care coordinators are specially trained to help members access the right healthcare providers, medications and other resources to manage their care and maintain their best health.
Some costs related to C-SNPs may include:
- Medicare Part B premium: Most Medicare members must continue to pay the monthly Medicare Part B medical premium. In 2023, the Part B premium is $164.90.
- C-SNP plan premium: Monthly plan premiums vary based on plan choice and location and may be as low as $0.
Cost-sharing expenses, such as:
- Deductibles are the set amount you pay for care before your plan kicks in.
- Copays are a set dollar amount you pay for prescriptions or healthcare provider visits at the time of service.
- Coinsurance is a percentage of costs you pay after you've met your deductible.
If you’re turning 65 and newly eligible for Medicare, you can join any Medicare SNP you qualify for during your Initial Enrollment Period. That starts 3 months before you turn 65, includes the month you turn 65 and ends 3 months after you turn 65.
You can also join any Medicare SNP you qualify for during the Medicare Annual Enrollment Period (AEP) between Oct. 15 – Dec. 7, with coverage beginning Jan. 1.
If you’re not yet 65 but already receiving Social Security benefits due to a qualifying chronic disability, you can sign up for a Medicare SNP plan from 3 months before to 3 months after your 25th month of disability.
If you already have Original Medicare or a Medicare Advantage plan and you’re diagnosed with a chronic condition, you can enroll in a C-SNP at any time, and your Special Election Period ends once you enroll in the plan.
If you have a C-SNP and your condition improves to the point that you’re no longer eligible, you’ll be disenrolled from the plan. However, you’ll be given a Special Election Period to enroll in a different Medicare Advantage plan or return to Original Medicare.
