Complete Guide to Medicare Special Needs Plans in Upshur County, WV
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For 2025, Upshur County, WV offers 9 Medicare Special Needs Plans (SNPs) tailored to meet diverse healthcare needs. These plans provide specialized coverage for those with particular conditions.
Our guide is here to help you navigate the choices and make the right selection.
Compare Medicare SNP Plans in Upshur County, WV
Below is a list of the 9 Medicare Special Needs Plans (SNPs) available in Upshur County, WV for 2025. Click on any plan to view full details, including eligibility, coverage, and costs, to find the best fit for your healthcare needs.
Upshur County, West Virginia Medicare SNP Plans
| Plan Name | Type | Premium | Network | Part D Deduct. |
Rating |
|---|---|---|---|---|---|
| Aetna Medicare Advantra Cares | D-SNP | $0 | HMO | $590 | |
| The Health Plan SecureCare SNP | D-SNP | $35 | HMO | $590 | |
| Humana Dual Select H5619-126 | D-SNP | $24 | HMO-POS | $590 | |
| Humana Gold Plus SNP-DE H5619-162 | D-SNP | $0 | HMO-POS | $590 | |
| Humana Together in Health | I-SNP | $0 | PPO | $470 | |
| WV Senior Advantage | I-SNP | $48 | HMO | $590 |
Understanding Medicare SNPs
Special Needs Plans (SNPs) under Medicare are designed to provide specialized coverage for individuals with unique healthcare needs. These plans offer benefits and services that are specifically aligned with the health challenges faced by their members.
There are three primary types of SNPs, each designed for a particular group of beneficiaries:
- Dual Eligible SNPs (D-SNPs): For those eligible for both Medicare and Medicaid, D-SNPs provide coordinated benefits, including additional services like care management and disease support. Learn more about these plans by reading our Comprehensive Guide for Dual Eligibles.
- Chronic Condition SNPs (C-SNPs): Targeted at individuals with chronic health conditions, C-SNPs provide specialized care and benefits designed to manage and treat these ongoing conditions.
- Institutional SNPs (I-SNPs): I-SNPs are geared towards individuals in long-term care settings or those needing nursing care at home, offering specialized and coordinated care.
Medicare SNP Eligibility Criteria in Upshur County
To enroll in an SNP, you must meet certain criteria related to your health or eligibility status. Discover what it takes to qualify for a Special Needs Plan.
Read: Understanding Medicare Special Needs Plans
Why Choose a Medicare SNP?
The specialized benefits offered by Medicare SNPs are tailored to meet the specific healthcare needs of individuals, providing additional services that help manage their conditions more effectively.
- Dual Eligible SNPs: D-SNPs coordinate care between Medicare and Medicaid, offering extra services such as transportation, care management, and/or assistance with daily living. These plans typically include comprehensive drug coverage with minimal copays.
- Chronic Condition SNPs: C-SNPs provide focused care management for chronic conditions like COPD or heart disease, offering tailored treatment plans and easier access to specialized care providers.
- Institutional SNPs: I-SNPs are designed to provide seamless care across nursing homes or in-home care settings, offering personalized health services like therapy and checkups, and possibly support for caregivers.
How to Choose the Best SNP for You in Upshur County, WV
Finding the right SNP for you can make a big difference in how well your healthcare needs are met. It’s essential to carefully compare your options to find a plan that suits your health and lifestyle. Just be aware that all types of SNP plan may not be available in Upshur County, WV.
- Consider Your Medical Needs: Assess your current health status and any special medical needs you may have. This will help you determine which type of SNP—D-SNP, C-SNP, or I-SNP—will best serve your needs.
- Examine Plan Benefits: Take a close look at the benefits provided by each SNP, including drug coverage, access to specialists, and other essential services. Select a plan that covers the healthcare services you rely on most.
- Check the Network: Make sure that your current doctors, specialists, and hospitals in the Upshur County area are part of the plan’s provider network. This ensures continuity of care and access to the providers you trust.
How to Enroll in a Medicare SNP
Getting enrolled in the right Medicare SNP is a crucial step in securing the specialized care you need. It’s important to be aware of the specific enrollment periods that allow you to join or switch plans.
Medicare beneficiaries have several opportunities each year to enroll in an SNP:
- Initial Enrollment Period (IEP): This is your first chance to enroll in Medicare and an SNP, lasting for seven months around your 65th birthday.
- Annual Enrollment Period (AEP): During the AEP, which runs from October 15 to December 7, Medicare Enrollees can join or switch SNPs for the coming year.
- Special Enrollment Periods (SEPs): If you experience certain life changes, such as a move or loss of coverage, you may qualify for an SEP to change your Medicare plan outside of the regular periods.
For more details on when to enroll, check out our detailed article on Medicare Advantage enrollment periods.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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