Medicare Advantage Special Needs Plans for chronic conditions offer additional healthcare coverage for people with severe or disabling conditions.

A Chronic Condition Special Needs Plan (C-SNP) is a type of Medicare Advantage care plan that provides additional targeted healthcare for people with severe and chronic medical conditions.

C-SNPs are offered by individual healthcare companies. They are either Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO) plan types.

C-SNPs provide the same Part A (hospital insurance) and Part B (medical insurance) coverage as all Medicare Advantage plans. They also cover Medicare Part D (drug coverage).

This article takes a closer look at C-SNPs, including eligibility requirements, cost, coverage, and enrollment.

A C-SNP provides healthcare benefits and services for people living with disabling health conditions.

To be eligible for C-SNP, you must have received a medical diagnosis for one or more of the following health conditions:

Additional eligibility requirements for a C-SNP include enrollment in Medicare Part A and Part B.

Medicare C-SNP plans are not available everywhere in the United States

It’s important to note that insurance companies choose which Medicare Advantage plans they’ll offer and where. This means C-SNPs may not be available in your location.

Medicare C-SNPs include all the coverage benefits of Medicare Part A and Part B. They also include prescription drug coverage (Medicare Part D). Some C-SNPs may also include coverage for routine dental, vision, and hearing care.

Depending on the plan, a C-SNP may also cover additional services tailored for chronic conditions. For example, a C-SNP might cover extra hospital days for people living with severe conditions like cancer or congestive heart failure.

All SNPs provide a care coordinator who works with you to develop a healthcare plan and answer any questions you may have about coverage or cost.

Can you use any doctor or facility that accepts Medicare?

Whether you can use any doctor or hospital that accepts Medicare varies by plan. If your C-SNP is an HMO, you’ll need to use doctors and facilities in your plan’s network (unless it’s for unplanned emergency care or out-of-the-area dialysis).

If your C-SNP is a PPO, you can get Medicare-covered services out of network, although you may need to pay more for these services.

If you’re considering enrolling in a C-SNP and you have a primary care doctor that you’d like to keep seeing, ask the plan’s insurance provider whether you can continue to see them and whether their services will cost more.

How much you’ll pay for a C-SNP depends on which plan you’ve enrolled in and where you live. Some C-SNPs charge premiums in addition to your monthly Medicare Part B premiums (which is $174.70 per month as of 2024).

The table below provides sample 2024 C-SNP plans and costs for Denver, Colorado.

C-SNP plan nameMonthly plan
premium		Part B
premium		Drug cost/
deductible		Copays/
Coinsurance		Maximum yearly cost
Select Health Medicare Essential (HMO)$0$174.70$0 / $0primary doctor: $0 copay

specialist: $25 per visit		$3,900 in-network
UHC Complete Care CO-001P (HMO-POS C-SNP)$0$174.70$0 / $0primary doctor: $0 copay

specialist: $0 to $10 per visit		$3,400 in-network
Kaiser Permanente Senior Advantage Core DM (HMO)$0$174.70$0 / $0primary doctor: $0 copay

specialist: $15 per visit		$3,900 in-network
HumanaChoice H5216-077 (PPO)$0$174.70$0 / $0primary doctor: $0 copay

specialist: $20 per visit		$6,700 in- and out-of-network

$3,900 in-network only

If you’ve just received a diagnosis of a chronic condition or have a worsening condition that makes you eligible for a C-SNP, you don’t have to wait for standard Medicare enrollment periods.

You can enroll in a C-SNP at any time as long as you meet eligibility requirements. Medicare calls these ”Special Enrollment Periods.”

You can use this online tool to explore C-SNP plans in your area. C-SNP plans are offered by Medicare-approved insurance companies

If you have any questions about signing up for a C-SNP or need help making enrollment changes, call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

In addition to C-SNPs for those with chronic conditions, Medicare Advantage offers two other types of Special Needs Plans:

Dual Eligible Special Needs Plan (D-SNP): D-SNPs are available for people who have enrolled in, or are eligible for, both Medicare and Medicaid. Depending on the plan, they may provide Medicaid and Medicare services. D-SNPs work with your state Medicaid program to help coordinate your Medicare and Medicaid benefits.

Institutional Special Needs Plan (I-SNP): You may qualify for an I-SNP if you’re a resident of a community but need the level of care provided by a healthcare facility, or you live (or are expected to live) for at least 90 days in a:

  • nursing home
  • intermediate care facility
  • rehabilitation hospital
  • long-term care facility
  • swing bed hospital
  • psychiatric hospital
  • another facility that offers similar long-term healthcare services

A Medicare Advantage SNP offers healthcare benefits and services to people with severe or disabling conditions, special healthcare needs, or both.

SNPs are offered by individual healthcare companies and are either HMO or PPO plan types. They provide the same Medicare Part A and Part B coverage as all Medicare Advantage plans. C-SNPs also cover Medicare Part D (drug coverage).

C-SNPs are tailored toward people with severe and disabling chronic conditions. Depending on the plan, they may offer extra services based on your unique healthcare needs. For example, they may include coverage for extra days in a hospital, care management specialists, or other social services.