"CMS will provide [a Special Enrollment Period (SEP)] for those individuals with severe or disabling chronic conditions to enroll in a [Medicare Advantage Special Needs Plan (SNP)] designed to serve individuals with those conditions. This SEP is available while the individual has the qualifying condition(s); it ends upon enrollment in the chronic care SNP.
Once the SEP ends, that individual may make enrollment changes only during applicable MA election periods [such as the AEP and MA-OEP].
In addition, individuals enrolled in a Chronic Care SNP who have a severe/disabling chronic condition which is not a focus of their current SNP are eligible for this SEP. Such individuals have an opportunity to enroll in a Chronic Care SNP that focuses on this other condition. Eligibility for this SEP ends at the time the individual enrolls in the new SNP." [formatting and links added]
2023 Special Needs – Chronic Care Plans Compared to the 2021 Plan Year |
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Chronic Care | Number of SNPs | ||||
2023 Plans | 2022 Plans | Net Change | 2021 Plans | 2020 Plans | |
Cardiovascular Disorders | 1 | 1 | 0 | 1 | 0 |
Cardiovascular Disorders and Chronic Heart Failure | 22 | 20 | 2 | 14 | 10 |
Cardiovascular Disorders and Diabetes | 5 | 4 | 1 | 6 | 2 |
Cardiovascular Disorders, Chronic Heart Failure and Diabetes | 164 | 141 | 23 | 93 | 67 |
Chronic and Disabling Mental Health Conditions | 2 | 5 | -3 | 3 | 2 |
Cardiovascular Disorders or Chronic Heart Failure or Diabetes Mellitus | 5 | 3 | 2 | 3 | 2 |
Chronic Heart Failure | 3 | 3 | 0 | 3 | 1 |
Chronic Heart Failure and Diabetes | 2 | 4 | -2 | 3 | 6 |
Chronic Lung Disorders | 35 | 29 | 6 | 23 | 16 |
Dementia | 6 | 8 | -2 | 7 | 8 |
Diabetes Mellitus | 36 | 34 | 2 | 34 | 37 |
End-stage Renal Disease Requiring Dialysis (any mode of dialysis) | 23 | 17 | 6 | 9 | 10 |
End-stage Renal Disease Requiring Dialysis or HIV/AIDS | 3 | 3 | 0 | 0 | 0 |
HIV/AIDS | 3 | 3 | 0 | 4 | 4 |
Total Chronic Illness SNPs | 310 | 275 | 35 | 203 | 165 |