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How Medicare works

Learning about Medicare can be a daunting task. But it doesn’t have to be. We are here, helping you understand the basics of Medicare (Parts A, B, C and D), the three main types of Medicare (Original, Medicare Advantage and Supplemental) and the enrollment timeline (all the way from signing to switching when a plan doesn’t meet your needs).

Chronic Conditions

If you are living with an ongoing health condition, you may be able to join a Chronic Condition Special Needs Plan (C-SNP). This is a special type of Medicare Advantage plan made for people with certain long-lasting health conditions, like diabetes or heart disease. 

To enroll in a C-SNP, you need to:

  • Be signed up for Medicare Parts A (hospital insurance) and B (medical insurance)
  • Have a qualifying chronic condition (your doctor must confirm the diagnosis before you can enroll)
  • Live in the area the plan covers
     

Each plan may cover different health conditions. The coverage can change based on the plan and where you live.

Common conditions that qualify include:

  • Diabetes
  • Heart conditions, such as heart disease or chronic heart failure
  • Lung conditions, such as chronic obstructive pulmonary disease (COPD) and emphysema
  • Kidney diseases, such as end-stage kidney disease

When you are living with a long-term health condition, you may need to take medicine daily, see several doctors and get additional tests. C-SNPs are made to help support these specific health needs.

C-SNP benefits:

  • Are designed to support your specific health condition – They help you manage it over time and often cover the medicines you need.
  • Include care coordination – This means the plan helps connect your doctors, prescriptions and services so your care works better together.
  • May be HMO or PPO plans – The type of plan is based on the provider and where you live.
  • Must follow a Model of Care approved by Medicare – This model explains how the plan supports members with chronic conditions through organized and ongoing care.
     

You can enroll in a C-SNP:

  • When you first qualify for Medicare. This is known as your Initial Enrollment Period. (Visit our enrollment timeline for more details.)
  • Every year from October 15 to December 7 during Medicare’s Annual Enrollment Period.
  • If you were recently diagnosed with a chronic condition. You may qualify for a Special Enrollment Period that allows you to change, join or drop a Medicare Advantage plan outside of the standard Annual Enrollment Period due to specific life events.
     

A C-SNP may be a good choice if you:

  • Have a qualifying long-term health condition
  • See more than one doctor or specialist
  • Take several medicines for your condition
  • Want help coordinating your care
  • Feel your current Medicare plan does not meet all of your needs
     

We currently offer a C-SNP for people with diabetes, chronic heart failure and cardiovascular disorders. For more information, please visit the HAP Medicare Diabetes and Heart (HMO C-SNP) plan page.

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