Get more support with an Aetna® C‑SNP
Do you have a chronic health condition like heart disease or diabetes? Sign up for a Chronic Condition Special Needs Plan (C‑SNP) plan to get extra care and support. And if you qualify, you may be able to enroll online.
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What is a C‑SNP?
An Aetna Chronic Condition Special Needs Plan (C‑SNP) is a Medicare Advantage plan with prescription drug coverage. You’ll get a team of doctors, nurses and other specialists who work together to create a care plan, just for you.
You might qualify to enroll in a C-SNP Medicare plan if you have at least one of the following conditions:
- Diabetes mellitus (high blood sugar)
- Chronic heart failure (CHF) (heart is unable to pump blood as it should)
- Cardiac arrhythmias (irregular heartbeats)
- Coronary artery disease (blocked blood vessels in the heart)
- Peripheral vascular disease (poor circulation in the arms and legs)
- Valvular heart disease (damage of flaps in the heart that control blood flow)
A C‑SNP is a Medicare Advantage plan with Part D prescription drug coverage.
Plus, you get a personal care team, low medical and prescription copays and an Aetna Medicare Extra Benefits Card to help pay for certain everyday expenses.
Support for the whole you
A C‑SNP helps you manage your chronic condition. You’ll get the care you need for your condition and save money on the things you use every day.
Help with certain everyday expenses
Members get a monthly allowance on an Extra Benefits Card for certain over-the-counter (OTC) health and wellness products.
$0 copays for primary care provider (PCP) and certain specialist visits
You’ll pay $0 copays for visits to certain in-network specialists* who treat your chronic condition.
Low copays for Rx drugs
$0 Tier 1 prescription drugs at in-network pharmacies to help with your chronic condition.
Personal care team
Works with your provider to develop your care plan and connects you with programs to help beyond health care services.
Diabetic supplies
Members will pay $0 for blood glucose meters (BGM) and test strips from our preferred diabetic suppliers.*
Dental, vision, hearing
Coverage that includes certain dental services, prescription eyewear and hearing aids.
What our members have to say
Aetna answers my doctor's request for treatment in days, not weeks. This allows me, the patient, to get the treatment faster so I can get back to my daily activities. I feel like I am valued as a member — and when you are talking about your health and well-being, you cannot beat that.”*
— Aetna Medicare member
Learn more about C‑SNPs
Is a C‑SNP right for you?
Watch this video or get more details about C‑SNPs. Learn how you may qualify for a C-SNP, what benefits a C‑SNP provides and what you need to enroll.
Are you eligible for Medicare and have you been diagnosed with diabetes or chronic heart failure?
If yes, then you may qualify for an Aetna Chronic Condition Special Needs Plan, or C-SNP.
This is a Medicare Advantage plan that offers specialized coverage, benefits and care for people living with qualifying chronic conditions like:
Diabetes Mellitus
Chronic Heart Failure or CHF
Or any of the following cardiovascular disorders:
cardiac arrhythmias
coronary artery disease
peripheral vascular disease
or valvular heart disease
At Aetna®, we understand that managing a chronic condition requires added care. That’s why we offer health and financial benefits you need to manage your condition and stay well.
Aetna® C-SNPs offer support that goes beyond traditional coverage.
Like $0 copays on all visits to your primary care provider and certain specialists like cardiologists, endocrinologists, nephrologists and pulmonologists.
And with Aetna®, you’ll also get personalized care. Every C-SNP includes a personal care team that understands your needs.
Your personal care team is led by a nurse care manager and, depending on your health needs, may include another nurses, social workers, medical directors, pharmacists and care coordinators.
Your care team can help you build your care plan, find doctors and schedule appointments. They can answer questions and help you manage your medications. And they can arrange meal services, local transportation to and from doctor visits, and more.
C-SNP members also get a monthly allowance on an Extra Benefits Card.
You can use this card for certain over-the-counter (OTC) health and wellness products.
Members with a qualifying condition who meet all other criteria can use the monthly allowance to help pay for additional everyday expenses, including:
healthy foods
utilities
transportation and
personal care products
C-SNPs also include dental, vision and hearing aid coverage.
And over 200 Tier 1 chronic condition prescription drugs have a $0 copay at in-network pharmacies. This makes it easier to afford the medicines you need.
Give us a call to learn about coverage in your area!
A licensed Aetna® agent can answer your questions and guide you through the enrollment process with no obligation to join.
They’ll also work directly with your doctors to make sure you qualify so you don’t have to.
Call us today at 1-844-602-1730 (TTY: 711) to learn more about C-SNP and other Medicare Advantage plans Aetna® has to offer.
Or visit us online at AetnaMedicare.com/Learn
How do I enroll in a C‑SNP?
To start, you’ll need the contact information for your primary care provider (PCP) or specialist. This should be the provider who treats you or has treated you for your chronic condition. They'll need to confirm (attest to) that condition. We’ll need this to fill out the Prequalification Assessment Tool (PQAT).
Next, we’ll send a Verification of Chronic Condition (VCC) form to the provider. They will confirm (attest to) your chronic condition. They’ll let us know if you have an eligible chronic condition and qualify for a C‑SNP. We need this form sent back to us before the end of the second month that you’re enrolled in the plan.
There are three ways you can enroll:
- Online: Fill out the enrollment form
- By phone: Call 1-844-619-5664 (TTY: 711), to talk to a licensed agent, 7 days a week, 8 AM to 8 PM.
- With a broker in your area: They can help you enroll.
What chronic conditions qualify for an Aetna C‑SNP?
To qualify for an Aetna C‑SNP plan, your provider will need to verify you have at least one of the following conditions:
- Diabetes mellitus (high blood sugar)
- Chronic heart failure (CHF) (Heart is unable to pump blood as it should)
- Cardiac arrhythmias (irregular heartbeats)
- Coronary artery disease (blocked blood vessels in the heart)
- Peripheral vascular disease (poor circulation in the arms and legs)
- Valvular heart disease (damage of flaps in the heart that control blood flow)
What if I don’t have an eligible condition and I enroll in a plan?
An Aetna C‑SNP is only for Medicare members who have at least one eligible chronic condition. If you enrolled and don’t have one of these conditions, you’ll be removed from the plan by the end of the second month.
When can I enroll?
Good news! If you have a qualifying condition for an Aetna C-SNP and haven’t enrolled in a C-SNP before, you qualify for a Special Enrollment Period (SEP) and can enroll anytime.
If you have already enrolled in a C-SNP and want to switch to a new plan, you still have options.
- Special Enrollment Period (SEP)
If you have a new chronic condition that’s not covered on your C-SNP, you’ll get a new SEP so you can enroll in another plan. You get one SEP for each new condition that qualifies.
- Annual Enrollment Period (AEP)
You can also enroll every year during the Medicare Annual Enrollment Period (AEP)/AEP. Medicare AEP begins on October 15 and ends on December 7.
It’s important that your doctor lets us know about your chronic condition by the end of your second month in the plan. If that doesn’t happen, you’ll be taken off of it. But don’t worry, you will get another SEP to sign up for a different Medicare plan, like Medicare Advantage, Medicare Advantage Prescription Plan, or Prescription Drug Plan.
Speak with a licensed Medicare agent. They can help you understand when to enroll. By phone: Call 1-844-619-5664 ${tty}, to talk to a licensed agent, 7 days a week, 8 AM to 8 PM.
How will my personal care team support me?
An Aetna C-SNP pairs each member with a team of health care professionals. Your care team works with you and your providers to develop your care plan. And they connect you with programs to help beyond health care services.
Your care team understands your plan benefits and helps you access the ones you need. If you want, they can schedule medical and dental appointments for you.
They can also connect you with local and state programs and resources to help you with meals, local transportation and more.
See plans in your area
Find out about your local Chronic Special Needs plan options. Check if your doctor is in network and your prescription drugs are covered. Start by entering your ZIP code.
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Disclaimer
*FOR MEMBER TESTIMONIAL: Member feedback has been edited for length and clarity.
Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our DSNPs 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. The Aetna Medicare pharmacy network includes limited lower cost, preferred pharmacies in: Rural Nebraska, Rural North Dakota, Suburban West Virginia, Urban Kansas, Urban Missouri. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, members please call the number on your ID card, non-members please call 1-855-338-7027 (TTY:711) or consult the online pharmacy directory at AetnaMedicare.com/pharmacyhelp.
The benefit(s) mentioned are part of special supplemental benefits for the chronically ill (SSBCI). SSBCI conditions include certain cardiovascular disorders, chronic heart failure, and diabetes. Eligibility is determined by whether you have a chronic condition associated with the benefit(s) and you meet all other criteria. Even if you have a listed chronic condition, you may not necessarily receive the benefit because other eligibility and coverage criteria may apply. Standards and conditions vary for each benefit. Contact us to confirm the specific SSBCI condition requirements for the benefit(s) for this plan and determine your eligibility. 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.
The Aetna C-SNP is available to Medicare members who have at least one of the qualifying chronic conditions. To ensure a successful enrollment process, we’ll confirm with your healthcare provider that you have one of these eligible conditions. If verification of eligible condition is not received, involuntary disenrollment will occur.
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.
Not all benefits are available in all plans. Visit AetnaMedicare.com to view plans in your area.