Managing a chronic condition can be overwhelming, stressful and expensive. You shouldn’t have to do it alone. That’s why Aetna® now offers a Medicare Advantage Chronic Condition Special Needs Plan, or C-SNP.  

C-SNPs are a type of Medicare plan for individuals living with chronic conditions. They are designed to deliver personal care and support as well as services and benefits that can help meet your unique health needs. 

If you have diabetes or heart disease, an Aetna C-SNP may be right for you. That’s why our plans bring together what matters most to your health. We want you to feel supported while getting the most value out of your health plan.

With a C-SNP you’ll have access to more benefits, coverage, hands-on support and savings to manage your condition. 

In this article, we’ll help you understand the ins and outs of a C-SNP plan. Then you can decide if it's the right fit for you and your health needs. Here’s what to know.

Who’s eligible for an Aetna C-SNP

If you have a diagnosis of diabetes or a certain heart disease, you may qualify for a Special Enrollment Period* (SEP) to enroll in an Aetna C-SNP plan. The full list of eligible chronic conditions is:  

• Diabetes (High blood sugar)

• Chronic heart failure (Enlarged heart and/or fluid on the lungs)

• Cardiac arrhythmias (Irregular heartbeat)

• Coronary artery disease (Heart blockages)

• Peripheral vascular disease (Poor circulation in hands and arms or feet and legs)

• Chronic venous thromboembolic disorder (Blood clots in your legs or lungs)

Aetna C-SNPs are now available in the Philadelphia/SouthEastern PA, Pittsburgh and Chicago areas.

The easiest way to find out if you qualify is by talking to a licensed Aetna agent. They can confirm your eligibility. And they can also answer all your questions at no cost.

All about C-SNP medical and drug coverage

C-SNPs are Medicare Advantage plans. A Medicare Advantage plan includes three parts:*

Medicare Part A (hospital insurance).

Part A covers:

• Inpatient care in hospitals
• Skilled nursing facility care
• Hospice care
• Home health care

Medicare Part B (medical insurance).

Part B covers:  

• Services from doctors and other health care providers
• Outpatient care
• Home health care
• Durable medical equipment (examples include wheelchairs, walkers and hospital beds.)
• Preventive services (examples include screenings, vaccines and yearly “wellness” visits)

Medicare Part D (drug coverage).

Part D covers the cost of approved prescription drugs as well as certain vaccines. With Aetna plans, you will get $0 or low cost copays at in-network pharmacies for covered Part D medications that treat your condition. 

Check your eligibility for an Aetna® Chronic Condition Special Needs Plan (C-SNP)

Find out if you qualify for an Aetna® C-SNP. We’re ready to answer your questions.

 

Contact us

More Aetna C-SNP benefits and resources

Aetna plans offer more coverage and benefits you wouldn’t normally get with Original Medicare or a typical Medicare Advantage plan. This means specialized support to help better manage your diabetes or heart disease. The specialized benefits may help you make the most out of your health plan. Aetna C-SNPs include:

A dedicated care team. Every Aetna member has a dedicated, personal care team ready to help with their unique health needs. A care manager leads your team. And it could include nurses, social workers, medical directors, pharmacists and care coordinators.

They can help take the stress out of getting the support you need by organizing your care plan and helping you best use your health benefits. Your Aetna care team can help you: 

• Find a PCP and specialists 
• Understand and manage your health condition and medications
• Schedule doctor visits 
• Find safe housing, local transportation, meal services and more

$0 copay. Members can take advantage of $0 or low-cost Part D covered prescription drugs at in-network pharmacies. This can help make your medicines less expensive for you. And it can make it easier to stay on top of your medicines, which is key to managing any chronic condition. Members also have a $0 copay on all visits to your primary care provider (PCP) and certain specialists who treat your chronic condition. These include:

• Cardiologists
• Endocrinologists 
• Nephrologists
• Pulmonologists

This helps you get both the regular and specialized care you need to manage your condition and stay as healthy as possible.

$0 monthly plan premium. Aetna offers C-SNPs with $0 monthly plan premiums.

A monthly allowance on the Aetna Medicare Extra Benefits Card to help pay for certain everyday expenses. Daily expenses can have a big impact on your well-being. So you can use your Extra Benefits Card to help pay for:

• Over-the-counter (OTC) health and wellness products
• Healthy foods
• Utilities
• Transportation
• Personal care products

Dental, vision and hearing coverage.

Aetna C-SNP plans also include vision, dental and hearing aid coverage. These are important benefits that can help lead to better overall health.  

Still have questions about how C-SNPs work? We can help answer them and work with you and your doctor to help you enroll.  

You can speak with a licensed Aetna agent for free. They're available at 1-844-521-4507 (TTY: 711) from 8 AM to 8 PM, 7 days a week, October 1 to March 31 and 8 AM to 8 PM, Monday to Friday, April 1 to September 30. 

How to enroll in a C-SNP

Call a licensed Aetna agent. They can answer your questions and guide you through the enrollment process at no cost. They can also help you complete the eligibility form and work with your provider to verify your condition. Your health care provider must respond by the end of your first month enrolled in the Aetna C-SNP plan. 

When you can enroll

• You may enroll in a C-SNP plan when you first receive a diagnosis of one of the six eligible chronic conditions.
• Once a quarter if you were not in a C-SNP plan before.
• The Initial Enrollment Period. This is when you first become eligible for Medicare. Your IEP is the 7-month period that begins three months before your 65th birthday, includes your birthday month and ends three months afterward. There is an exception if your birthday falls on the first of any month. In that case, your 7-month IEP begins and ends one month sooner.
• Annual Enrollment Period. It runs from October 15 to December 7 every year.
• Special Enrollment Periods (SEPs)*. SEPs happen after certain qualifying life events. These include having a diagnosis of a covered condition, or a new diagnosis of a covered condition, moving or losing other health care coverage.

Ready to learn more? Give us a call. We look forward to helping and supporting you to manage your unique health needs. Disponible en espanol. 

*FOR PARTS OF MEDICARE: Medicare.gov. Parts of Medicare. Accessed July 26, 2024.

*Special Enrollment Periods (SEPs). SEPs happen after certain qualifying life events. These include a new diagnosis of a covered condition, moving or losing other health care coverage.

To qualify for a C-SNP you must be eligible for Medicare and have at least one of the eligible chronic conditions. If you do not have an eligible chronic condition, you will be disenrolled from the C-SNP.

Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our C-SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. Plan features and availability may vary by service area. Participating health care providers are independent contractors and are neither agents nor employees of Aetna. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. To send a complaint to Aetna, call the Plan or the number on your member ID card. To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance. 

The benefits mentioned are part of special supplemental program for the chronically ill. Eligibility is determined by whether you have a chronic condition associated with this benefit. Standards may vary for each benefit. Conditions include Hypertension, Hyperlipidemia, Diabetes, Cardiovascular Disorders, Cancer.  Other eligible conditions may apply. Contact us to confirm your eligibility for these benefits. 

This material is for informational purposes only and is not medical advice. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Contact a health care professional with any questions or concerns about specific health care needs. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna is not a provider of health care services and, therefore, cannot guarantee any results or outcomes. The availability of any particular provider cannot be guaranteed and is subject to change. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to our website. 

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