On this page we help consumers: Find and compare Medicare Special Needs Plans in Berks County, Pennsylvania. Compare SNP premiums, deductibles, co-payments, supplemental benefits, star ratings, and more.
|Aetna Medicare Advantra Cares||$20.40||Dual-Eligible||Local HMO|
|UnitedHealthcare Nursing Home Plan 2||$35.40||Institutional||Local PPO|
|UnitedHealthcare Dual Complete||$22.90||Dual-Eligible||Local HMO|
|BlueJourney Alliance Heart and Diabetes Care||$25.00||Chronic or Disabling Condition||Local HMO|
|Humana Gold Plus SNP-DE H6622-038||$28.20||Dual-Eligible||Local HMO|
|BlueJourney Alliance Lung Care||$33.00||Chronic or Disabling Condition||Local HMO|
|Geisinger Gold Secure Rx||$35.60||Dual-Eligible||Local HMO|
|Gateway Health Medicare Assured Ruby||$35.60||Dual-Eligible||Local HMO|
|AmeriHealth Caritas VIP Care||$35.60||Dual-Eligible||Local HMO|
|Gateway Health Medicare Assured Diamond||$35.60||Dual-Eligible||Local HMO|
|UPMC for Life Dual||$35.60||Dual-Eligible||Local HMO|
|BlueJourney Alliance Assisted Care||$40.00||Institutional||Local HMO|
|Health Partners Medicare Special||$35.60||Dual-Eligible||Local HMO|
|Allwell Dual Medicare||$34.00||Dual-Eligible||Local HMO|
Unlike Medicare prescription drug plans in Pennsylvania, which are the same statewide, Medicare Special Needs Plan (SNP) availability and options vary by area. The reason for this is simple. Not all areas have the same healthcare providers or needs, so localized plans are best. And, even though SNPs are private health plans, like Medicare Advantage plans in Berks County, PA, enrollment requirements are different.
Getting Enrolled in a Berks County Medicare Special Needs Plan
Not everyone qualifies to join a SNP plan. To qualify as a person with special needs you must meet one or more of the following criteria:
- An institutionalized individual,
- A dual-eligible (Medicare and Medicaid) person, or
- An individual with a severe or disabling chronic condition.
For those 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).
You also have an Individual Election Period (IEP). Your IEP begins the month before your 65th birthday, includes your birth month, and continues the month after your birth month.
In addition to the periods outlined above, you may be able to join a SNP with a Special Election Period in certain situations. 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.
There are three ways to enroll in an SNP:
- Call our Trusted Partner at 1-855-266-4865. This toll-free number is staffed by HealthPlanOne, 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.