Special Needs Plans, Baldwin County, AL, 2024
We reviewed the top 26 Medicare Advantage Special Needs Plans (SNPs) available in Baldwin County, Alabama for 2024. This is what we learned:
Key Facts
- Special Needs Plans are not available to everyone. Membership is limited to people with specific diseases or characteristics.
- The average premium for a Special Needs Plan in Baldwin County is $36.58 per month.
- If you are dual eligible (Medicare and Medicaid), most of your healthcare costs are fully covered.
- SNPs cover the same services that all Medicare Advantage plans must cover.
- SNPs may also cover extra services tailored to the special groups they serve, like extra days in the hospital.
- All SNPs include a Medicare Part D drug plan. The average drug plan deductible is $476.77 per year.
- SNPs tailor plan benefits, provider choices, and drug formularies to meet the specific needs of the groups they serve.
- Medicare rated 68% of all SNPs in Baldwin County 4 stars or higher.
Baldwin County, Alabama Medicare SNP Plans
Plan Name | Type | Premium | Network | Part D Deduct. |
Rating |
---|---|---|---|---|---|
UHC Care Advantage EX-E002 | I-SNP | $41 | PPO | $0 | |
UHC Nursing Home Plan EX-F001 | I-SNP | $32 | PPO | $545 | |
VIVA Medicare Extra Value | D-SNP | $41 | HMO | $529 | |
HumanaChoice SNP-DE H5216-370 | D-SNP | $41 | PPO | $545 | |
UHC Dual Complete AL-D002 | D-SNP | $39 | PPO | $545 | |
Aetna Medicare Dual Preferred | D-SNP | $40 | HMO | $545 | |
Aetna Medicare Dual Select | D-SNP | $32 | HMO | $545 | |
Aetna Medicare Dual Signature | D-SNP | $41 | HMO | $545 | |
Aetna Medicare Dual Signature Select | D-SNP | $39 | HMO | $545 | |
Cigna TotalCare | D-SNP | $29 | HMO | $545 | |
Cigna TotalCare Plus | D-SNP | $33 | HMO | $545 | |
Humana Gold Plus SNP-DE H5619-093 | D-SNP | $41 | HMO | $545 | |
UHC Complete Care AL-0005 | C-SNP | $0 | HMO-POS | $0 | |
UHC Dual Complete AL-D001 | D-SNP | $36 | HMO-POS | $545 | |
UHC Dual Complete AL-V002 | D-SNP | $41 | HMO-POS | $545 | |
Wellcare All Dual Assure | D-SNP | $20 | HMO | $545 | |
Wellcare Dual Access | D-SNP | $24 | HMO | $545 | |
Wellcare Dual Access Open | D-SNP | $26 | PPO | $545 | |
Wellcare Dual Liberty | D-SNP | $25 | HMO | $545 | |
Simpra Advantage | D-SNP | $41 | PPO | $545 | |
Simpra Advantage | I-SNP | $41 | PPO | $545 | |
Simpra Advantage Premier | I-SNP | $98 | PPO | $150 |
Baldwin County, AL
Medicare Advantage Special Needs Plan Information
Medicare Advantage Special Needs Plans (SNPs) are an alternative to Original Medicare. However, SNPs are not available to all Medicare beneficiaries in Baldwin County. There are currently 26 SNPs available. Each plan is managed by a Medicare-approved private health plan following the strict rules and requirements set by Medicare.
To join a SNP you must first prove you have special needs based on one or more of the following three criteria:
- An institutionalized individual,
- A dual-eligible (Medicare and Medicaid) person, or
- An individual with a severe or disabling chronic condition.
There are Different Types of Special Needs Plans
There are three different types of Medicare Advantage Special Needs Plans:
- Dual-eligible SNPs (D-SNP) are for people who qualify for both Medicare and Medicaid.
- Institutional SNPs (I-SNP) are for beneficiaries who are institutionalized and live in long-term care or a skilled nursing facility.
- Chronic Condition SNPs (C-SNP) are for people with one or more chronic conditions, including diabetes, end-stage renal disease (ESRD), lung conditions or heart disease.
D-SNP
Dual Eligible Special Needs Plans (D-SNPs) accept people who are eligible for both Medicare and Medicaid. Alabama covers some Medicare costs, depending on the individual’s eligibility. Medicaid eligibility categories include:
I-SNP
Institutional Special Needs Plans (I-SNPs) are SNPs that restrict enrollment to Medicare beneficiaries who, for 90 days or longer, have had or are expected to need the level of services provided in a long-term care facility, skilled nursing facility, an intermediate care facility for individuals with intellectual disabilities, or an inpatient psychiatric facility.
Prior to enrolling in a I-SNP, beneficiaries are advised to verify their institution accepts the plan and that its healthcare providers are in the plan's provider network.
C-SNP
Chronic Condition SNPs restrict enrollment to special needs individuals with severe or disabling chronic conditions. About two-thirds of Medicare enrollees have multiple chronic conditions requiring coordination of care among primary care providers, medical and mental health specialists, inpatient and outpatient facilities, and extensive ancillary services related to diagnostic testing and therapeutic management.
There are 15 SNP-specific chronic conditions::
- Chronic alcohol and other drug dependence
- Autoimmune disorders (limited)
- Cancer, excluding pre-cancer conditions or in-situ status
- Cardiovascular disorders (limited)
- Chronic heart failure
- Dementia
- Diabetes mellitus
- End-stage liver disease
- End-stage renal disease (ESRD) requiring dialysis
- Severe hematologic disorders (limited)
- HIV/AIDS
- Chronic lung disorders (limited)
- Chronic and disabling mental health conditions (limited)
- Neurologic disorders (limited)
- Stroke
Medicare SNP Enrollment Periods
For those Baldwin County residents who qualify, there are several different Medicare Election Periods. This is when you can join or change your plan. Most people wait until 15 October to 7 December to make enrollment changes. This is the Annual Election Period (AEP).
Most of us also get an Individual Election Period (IEP), but it only comes around once. Your IEP is based on your 65th birthday. It starts three months before your birth month and ends three months after, so you have plenty of time.
Outside of these periods, you may be able to join a Special Needs Plan with a Special Election Period. Some situations that may qualify you for a Special Election Period include:
- You are diagnosed with a severe or disabling condition: You can enroll in a Chronic-Condition Special Needs Plan (C-SNP) for beneficiaries with your illness at any time.
- You move into a nursing home or require skilled nursing care at home: You can enroll in an Institution Special Needs Plan (I-SNP) or switch plans at any time.
- You qualify for Medicaid: If you have Medicaid or are newly eligible for Medicaid, you can enroll in a Dual-Eligible Medicare Special Needs Plan (D-SNP) at any time.
- You move outside of your existing Special Needs Plan’s service area: You'll qualify for a Special Election Period to switch to a new plan.
- Your Special Needs Plan leaves the Medicare program: You'll qualify for a Special Election Period to switch plans.
How to Enroll in a Medicare Special Needs Plan in Baldwin County
There are three ways to enroll in an SNP:
- Call our Trusted Partner at 1-855-728-0510 (TTY 711). This toll-free number is staffed by HealthCompare, the outsourced partner of choice for some of the nation’s largest health plans.
- Call a plan directly. If you know the plan you want, this way is quick and easy. All of our plan pages provide contact information.
- Go to www.Medicare.gov and enroll through the government website. From there you can look up your medications, compare plans, and get your application started online.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
Citations & References
- CMS.gov, 2024 SNP Landscape Source Files, Last Accessed October 14, 2023
- CMS.gov, "Special Needs Plans (SNP)", Last Accessed September 11, 2023
- CMS.gov, "Institutional Special Needs Plans (I-SNPs)", Last Accessed September 11, 2023
- Medicare.gov, "Your health plan options", Last Accessed May 17, 2023