C-SNP Plans for Chronic Conditions

What Is a C-SNP?

A C-SNP is a Medicare Advantage plan built for people with a serious, long-term illness. C-SNPs are built around the specific care needs of people managing these conditions, with tailored formularies, care management programs, and specialist networks.

Qualifying Chronic Conditions

Medicare lists the illnesses that qualify you for a C-SNP. The common ones are:

• Diabetes
• Cardiovascular disorders (including chronic heart failure and coronary artery disease)
• Chronic obstructive pulmonary disease (COPD)
• End-stage renal disease (ESRD)
• Certain types of cancer
• Dementia
• Severe hematologic disorders
• HIV/AIDS
• Autoimmune disorders
• Neurological disorders

Each C-SNP is limited to a single condition or a closely related set of conditions. You must have a qualifying diagnosis to enroll.

What Makes C-SNPs Different?

C-SNPs are required by CMS to provide tailored care for their target population. This typically means:

• Better drug lists: The plan covers the medicines people with your condition usually take.
• A care manager: One person helps you keep track of your care.
• The right specialists: The plan includes the doctors who treat your condition.
• Extra help for your illness: Some C-SNPs add benefits tied to your condition, like glucose monitors for a diabetes C-SNPs).

Enrollment Periods

If you have a qualifying chronic condition, you have a Special Enrollment Period (SEP) to join, switch, or leave a C-SNP at any time during the year. You must provide documentation of your qualifying condition.