The Plan has available a Special Needs Plan (SNP) that has been developed for members who elect a plan that provides a specialized benefit structure. These SNPs assist the member in the management of their disease. The following are the Special Needs Plans:
- Chronic Combined Plan for Diabetes, Cardiovascular Disease and Chronic/Congestive Heart Failure;
- Chronic Pulmonary Disease; and
- Dual-Eligible Plan (for members with Medicare and Medicaid benefits).
Enrollment into the SNP is determined at the time a member enrolls and elects to become a member of one of these special benefit plans. They must complete a Pre‐Enrollment questionnaire on which they state they have one of the diseases mentioned above. This diagnosis must then be confirmed by the member’s physician.
All members who are enrolled into a SNP may participate in the Case Management Program for evaluation and assistance with care coordination. The use of Care plans and physician, member and caregiver involvement is an ongoing management and evaluation activity in order to achieve developed goals.
The Case Management Program is on a voluntary basis for members who choose to receive assistance from a nurse and/or social worker.
For more information on how to enroll into one of these plans, please call Member Services at (800) 401-2740.