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 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.

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.

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Who’s eligible for an Aetna C-SNP

To qualify for an Aetna C-SNP plan, you must be 65 or older and have one or more of the following chronic conditions: 

• 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)

You must also be a U.S. citizen or have lived in the country for at least five years as a legal resident. And you must live in a C-SNP service area. They are now available in the Philadelphia/South Eastern 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 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. 

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Additional Aetna C-SNP benefits and resources

Aetna plans offer more coverage and benefits you wouldn’t normally get with Original Medicare. Additional support can 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 care needs. A care manager leads your care team. Depending on your health needs, your team may also include nurses, social workers, medical directors, pharmacists and care coordinators.

Your team 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. Here are some ways your Aetna care team can help you:

• Find a PCP and specialists 
• Help you understand and manage your health condition
• 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 specialists are:

• 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. Unlike some other health plans, you don’t have to pay every month to keep your health coverage.

Monthly Extra Supports benefit amount (allowance) on the 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 Supports Wallet 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 your questions and work with you and your doctor to enroll.  

You can speak with a licensed Aetna agent for free. They're available at 1-888-210-7634 (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. 

Checking your C-SNP eligibility is easy

A licensed Aetna agent can see if you qualify for a C-SNP. Then they’ll guide you through the enrollment process from start to finish — for free. Speak with a licensed Aetna agent today. Schedule a call.

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.
• Initial Enrollment Period. This starts three months before your 65th birthday and continues for seven months after your birthday. 
• 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 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.

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. 

Eligibility for the Model Benefit or Reward and Incentive (RI) Programs under the Value-Based Insurance Design (VBID) Model is not assured and will be determined by Aetna after enrollment, based on relevant criteria (e.g., clinical diagnoses, eligibility criteria, participation in a disease state management program). 

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