Healthcare Educators


Medicare Options for Clients with Chronic Conditions

by | Feb 23, 2021

Chronic conditions are common among seniors. More than one in four seniors has diabetes, according to the American Diabetes Association, while more than one in five seniors has coronary heart disease, according to the CDC. The prevalence of many other chronic conditions, including dementia and cancer, can also increase with age.

Medicare enrollees with chronic conditions may need additional medical care and resources. More and more Medicare plans are providing these benefits – and agents can help seniors find these plans.

Special Needs Plans for Chronic Conditions

Medicare enrollees with chronic conditions may be able to enroll in a Chronic Condition Special Needs Plan, or C-SNP.

C-SNPs are a special type of Medicare Advantage plan designed to serve Medicare enrollees with a specific chronic condition. Different C-SNPs cater to different chronic conditions. These chronic conditions can include stroke, diabetes, cancer, dementia, cardiovascular disorders, and other conditions. C-SNPs will cover all the Medicare services that regular Medicare Advantage plans must cover, and they may also provide additional benefits specially tailored to the groups they serve.

To enroll in a C-SNP, a Medicare beneficiary must meet the enrollment requirements of a plan in their service area. For example, if a Medicare beneficiary with diabetes is interested in joining a C-SNP, they would look for C-SNPs designed for people with diabetes in their region.

The number of C-SNPs is growing. According to the Medicare Advantage 2021 Spotlight, there are 203 C-SNPs being offered in 2021. This is a significant increase from 2020, when 165 C-SNPs were offered. This means that Medicare enrollees who couldn’t find a suitable C-SNP in previous years may be able to find one now.

Medicare enrollees who meet the enrollment requirements for a C-SNP may also qualify for a Special Enrollment Period. This means they won’t have to wait until the next enrollment period to join a plan.

Medicare Advantage Plans with Supplement Benefits

Some regular Medicare Advantage plans also offer supplemental benefits not provided under Original Medicare. These benefits can include things like meal delivery and transportation – benefits that aren’t medical in nature but can help enrollees with chronic conditions and mobility issues.

According to Fierce Healthcare, recent data shows that the number of Medicare Advantage plans offering supplemental benefits is growing. In 2021, supplemental benefits increased in 36 out of 41 categories, including 17 out of 19 chronically ill categories. Some of the most significant increases were seen in benefit offerings for enrollees with diabetes and behavioral health diagnoses.

When looking at Medicare Advantage plans for your clients, pay careful attention to new supplemental benefits that can help enrollees with chronic conditions. Need assistance? Contact PTT.