Chronic Condition Special Needs Plans (C-SNP)

C-SNP plans are Medicare Advantage plans designed for people with certain CMS-designated chronic conditions. Eligibility is based on diagnosis, not Medicaid. Availability varies by Utah county.

General information only — not a recommendation of any plan. Plan availability, costs, and benefits vary by county and eligibility.

What is a C-SNP?

A Chronic Condition Special Needs Plan (C-SNP) is a type of Medicare Advantage plan tailored for people with one or more qualifying chronic conditions. Benefits, networks, formularies, and care management may be designed around those conditions. Each plan targets a specific condition or related group of conditions and must be approved by CMS.

Who is eligible?

• Medicare Part A and Part B
• Live in the plan's service area
• Have a diagnosis of the chronic condition(s) the plan covers

You do not need Medicaid to qualify for a C-SNP (unlike D-SNP). Eligibility is based on your condition diagnosis and plan criteria — not guaranteed by reading this page.

Common CMS condition categories

Examples of conditions CMS has associated with C-SNP designs include (availability varies): diabetes; chronic heart failure; coronary artery disease and other cardiovascular disorders; COPD; ESRD / chronic kidney disease; autoimmune disorders; severe hematologic disorders; certain chronic mental health conditions; neurological disorders; chronic liver disease; certain cancers; HIV/AIDS; and some condition combinations. Not every category is offered in every Utah county.

How C-SNPs may differ

• Formulary focused on medications commonly used for the target condition
• Networks with specialists experienced in that condition
• Condition-related extra benefits (plan-specific)
• Care management, including a Health Risk Assessment (HRA) and individualized care planning

A C-SNP is not automatically a better choice than a standard Medicare Advantage plan. Compare networks, drugs, costs, and care needs carefully.

Enrollment periods

You may enroll during your Initial Coverage Election Period, the Annual Enrollment Period (October 15 – December 7), or a Special Enrollment Period if you newly qualify (for example, a new qualifying diagnosis) or other CMS rules apply. Unlike many duals in D-SNPs, C-SNP members do not automatically get a monthly SEP solely because of the chronic condition.

Utah availability

C-SNP availability varies by county and year. We can check what is offered through the carriers we represent in your area. We do not offer every plan available in your area.