"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]
2025 Special Needs – Chronic Care Plans Compared to the 2024 Plan Year |
|||||
Chronic Care | Number of SNPs | ||||
2025 Plans | 2024 Plans | Net Change | 2023 Plans | 2022 Plans | |
Cardiovascular Disorders | 1 | 0 | 1 | 1 | 1 |
Cardiovascular Disorders, Chronic Heart Failure | 1 | 14 | -13 | 22 | 20 |
Cardiovascular Disorders, Diabetes Mellitus | 6 | 6 | 0 | 5 | 4 |
Cardiovascular Disorders, Chronic Heart Failure, Diabetes Mellitus | 278 | 194 | 84 | 164 | 141 |
Chronic Disabling Mental Health | 0 | 0 | 0 | 2 | 5 |
Cardiovascular Disorders or Chronic Heart Failure or Diabetes Mellitus | 0 | 3 | -3 | 5 | 3 |
Chronic Heart Failure | 1 | 2 | -1 | 3 | 3 |
Chronic Heart Failure, Diabetes | 2 | 2 | 0 | 2 | 4 |
Chronic Lung Disorders | 31 | 29 | 2 | 35 | 29 |
Dementia | 1 | 4 | -3 | 6 | 8 |
Diabetes Mellitus | 11 | 21 | -10 | 36 | 34 |
End-Stage Renal Disease | 41 | 32 | 9 | 23 | 17 |
End-stage Renal Disease Requiring Dialysis or HIV/AIDS | 0 | 0 | 0 | 3 | 3 |
HIV/AIDS | 1 | 1 | 0 | 3 | 3 |
Total Chronic Illness SNPs | 374 | 308 | 66 | 310 | 275 |