C-SNP

Chronic Condition Special Needs Plans (C-SNPs) are a form of Medicare Advantage available to those who, according to the Center for Medicare and Medicaid Services, (CMS) “who have one or more comorbid and medically complex chronic conditions that are substantially disabling or life threatening; have a high risk of hospitalization or other significant adverse health outcomes; and require specialized delivery systems across domains of care.”

In other words, you are eligible for a C-SNP plan if you are suffering from a chronic health condition.

List of Conditions Covered by a C-SNP Plan

To understand if your condition is covered under a C-SNP, they are broken down into four general categories:

Group 1: Diabetes mellitus and chronic heart failure;
Group 2: Chronic heart failure and cardiovascular disorders;
Group 3: Diabetes mellitus and cardiovascular disorders;
Group 4: Diabetes mellitus, chronic heart failure, and cardiovascular disorders; and
Group 5: Stroke and cardiovascular disorders.

These groups each include specific conditions that are eligible for a C-SNP plan. Here is an expanded list to help you better understand your eligibility:

Chronic alcohol and other drug dependence

Autoimmune disorders limited to:
Polyarteritis nodosa
Polymyalgia rheumatica
Polymyositis
Rheumatoid arthritis
Systemic lupus erythematosus

Cancer (excluding pre-cancer conditions or in-situ status)

Cardiovascular disorders limited to:
Cardiac arrhythmias
Coronary artery disease
Peripheral vascular disease
Chronic venous thromboembolic disorder

Chronic heart failure
Dementia
Diabetes mellitus
End-stage liver disease
End-stage renal disease (ESRD) requiring dialysis

Severe hematologic disorders limited to:
Aplastic anemia
Hemophilia
Immune thrombocytopenic purpura
Myelodysplastic syndrome
Sickle-cell disease (excluding sickle-cell trait)

HIV/AIDS

Chronic lung disorders limited to:
Asthma
Chronic bronchitis
Emphysema
Pulmonary fibrosis
Pulmonary hypertension

Chronic and disabling mental health conditions limited to:
Bipolar disorders
Major depressive disorders
Paranoid disorder
Schizophrenia
Schizoaffective disorder

Stroke

Neurologic disorders limited to:
Amyotrophic lateral sclerosis (ALS)
Epilepsy
Extensive paralysis (i.e., hemiplegia, quadriplegia, paraplegia, monoplegia)
Huntington’s disease
Multiple sclerosis
Parkinson’s disease
Polyneuropathy
Spinal stenosis
Stroke-related neurologic deficit

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