Understanding Medicare Special Needs Plans in El Paso County, Colorado
Understanding Medicare Special Needs Plans in El Paso County, Colorado
Explore 17 Medicare Special Needs Plans (SNPs) available in El Paso County for 2025. These plans are designed for individuals with specific healthcare needs, including chronic conditions, long-term care, or dual eligibility for Medicare and Medicaid.
Review your plan options below, or for personalized help, call 1-877-388-0596 (TTY 711) to connect with a licensed HealthCompare agent.
Exploring Available Special Needs Plans in El Paso County
Medicare Special Needs Plans (SNPs) are customized to address various healthcare needs. There are different types of SNPs, each created to offer tailored benefits for specific groups of individuals, but some areas of Colorado will not have all plan types:
- Dual Eligible SNP Plans (D-SNP): El Paso offers 9 D-SNP plans, {dsnp_5star_plans} of which have a 4-5 star rating. The average premium for these plans is {ave_dsnp_premium}, and they combine Medicare and Medicaid benefits to simplify healthcare management.
- Chronic Condition SNP Plans (C-SNP): There are 2 C-SNP plans in El Paso, with {csnp_5star_plans} plans rated 4-5 stars. The average premium for these plans is {ave_csnp_premium}. C-SNPs provide specialized care for individuals with chronic health conditions.
- Institutional SNP Plans (I-SNP): El Paso has 3 I-SNP plans available, with {isnp_5star_plans} of them earning a 4-5 star rating. These plans are designed for individuals living in long-term care facilities or those who require ongoing skilled nursing care.
Dual Eligible Special Needs Plans (D-SNPs)
Created for those eligible for both Medicare and Medicaid, these plans provide coordinated care by integrating benefits from both programs. The Medicare Plan Compare tool on Medicare.gov can help you navigate your choices.
El Paso County, Colorado D-SNP Options
Plan Name | Rating | Premium | Network |
---|---|---|---|
Select Health Medicare Dual | 46.60 | HMO | |
HumanaChoice SNP-DE H5216-267 | 46.60 | PPO | |
UHC Dual Complete CO-S001 | 46.60 | PPO | |
UHC Dual Complete CO-S002 | 46.60 | HMO-POS | |
UHC Dual Complete CO-V001 | 46.60 | PPO | |
Aetna Medicare Assure Premier | 35.50 | HMO | |
Anthem Dual Advantage | 45.10 | HMO | |
Cigna TotalCare | 29.20 | HMO | |
Cigna TotalCare Plus | 26.00 | HMO |
Factors to Consider for D-SNP Plans
- Medicaid Eligibility: D-SNPs are designed for individuals who qualify for both Medicare and Medicaid. Ensure that you meet the eligibility requirements for Medicaid in your state.
- Question to ask: Am I eligible for Medicaid benefits in addition to Medicare?
- Provider Network: Confirm that your preferred healthcare providers, including doctors and hospitals, are part of the D-SNP plan's network to avoid out-of-network costs.
- Question to ask: Are my doctors and hospitals in this plan’s network?
- Integrated Benefits: D-SNPs integrate Medicare and Medicaid benefits, which can simplify your healthcare management. Check what specific benefits are included in your plan.
- Question to ask: What additional benefits are provided by this D-SNP plan?
- Prescription Drug Coverage: Most D-SNPs include prescription drug coverage. Review the formulary to ensure your medications are covered.
- Question to ask: Does this plan cover my current prescriptions?
Ready to explore your D-SNP options further? Speak with a licensed HealthCompare agent today at 1-877-388-0596 (TTY 711).
Institutional Special Needs Plans (I-SNPs)
Designed for individuals living in long-term care facilities, like nursing homes, or those needing prolonged skilled nursing care at home, these plans offer specialized coverage. You can find more information about I-SNPs and their benefits on the CMS website.
El Paso County, Colorado I-SNP Options
Plan Name | Rating | Premium | Network |
---|---|---|---|
UHC Care Advantage CO-E001 | 34.00 | PPO | |
UHC Nursing Home Plan CO-F001 | 25.60 | PPO | |
Longevity Health Plan | 46.60 | HMO |
Factors to Consider for I-SNP Plans
- Long-Term Care Needs: I-SNPs are designed for individuals in long-term care facilities or those needing ongoing skilled nursing care. Ensure the plan covers the level of care you require.
- Question to ask: Does this plan cover my specific long-term care needs?
- Facility Network: Confirm that the long-term care facilities or skilled nursing providers you prefer are in the plan’s network to avoid out-of-network costs.
- Question to ask: Are my preferred care facilities and providers in-network?
- Care Team Support: I-SNPs often include dedicated care teams to coordinate your care. Verify that the plan provides access to a care team that meets your needs.
- Question to ask: Will I have access to a dedicated care team under this plan?
- Prescription Drug Coverage: Most I-SNPs include prescription drug coverage. Check the plan’s formulary to ensure that your medications are covered.
- Question to ask: Are my medications covered, and what are the copays?
Ready to explore your I-SNP options further? Speak with a licensed HealthCompare agent today at 1-877-388-0596 (TTY 711).
Chronic Condition Special Needs Plans (C-SNPs)
These plans are designed for individuals with severe or disabling chronic conditions. C-SNPs excel at coordinating your care among different medical specialists and often include extra benefits like prescription drug plans.
El Paso County, Colorado C-SNP Options
Plan Name | Rating | Premium | Network |
---|---|---|---|
UHC Complete Care CO-002P | 0.00 | HMO-POS | |
Anthem Kidney Care | 0.00 | HMO |
Factors to Consider for C-SNP Plans
- Chronic Condition Management: C-SNPs are designed for individuals with specific chronic conditions. Make sure the plan covers your condition and offers specialized care that meets your needs.
- Question to ask: Does this plan provide specialized care for my chronic condition?
- Care Coordination: C-SNPs often provide coordinated care among different healthcare providers. Verify that the plan includes access to specialists who treat your condition.
- Question to ask: Does this plan offer coordinated care with specialists I need?
- Extra Benefits: C-SNPs may offer additional benefits such as wellness programs or disease management services.
- Question to ask: What extra benefits does this C-SNP plan offer for managing my condition?
- Prescription Drug Coverage: C-SNPs generally include prescription drug coverage. Review the formulary to ensure your medications are covered and affordable.
- Question to ask: Are my medications covered, and what are the associated costs?
Ready to explore your C-SNP options further? Speak with a licensed HealthCompare agent today at 1-877-388-0596 (TTY 711)
How and When to Enroll in a Special Needs Plan in El Paso County
Enrolling in a Medicare Special Needs Plan (SNP) in El Paso County involves understanding the different enrollment periods. Whether you're new to Medicare or want to change your current coverage, knowing when and how to enroll is key to getting the right plan for your health needs.
When to Enroll
- Initial Enrollment Period (IEP): Starting three months before your 65th birthday and lasting until three months after, this is your first chance to enroll in Medicare. Learn more: Medicare IEP Guide.
- Medicare Advantage Open Enrollment Period (MA OEP): Between January 1 and March 31, you can switch your Medicare Advantage Plan, including SNPs. Learn more: MA OEP Guide.
- Annual Enrollment Period (AEP): From October 15 to December 7, this period allows most people to adjust their Medicare plans. Learn more: AEP Guide.
- Special Enrollment Periods (SEPs): If you qualify due to certain life events, such as moving or losing other coverage, you may be eligible for a Special Enrollment Period. Learn more: SEP Guide.
How to Enroll
To enroll in a Medicare Special Needs Plan, you have several options:
- Consult a Licensed Agent: For personalized help, contact a licensed HealthCompare agent at 1-877-388-0596 (TTY 711).
- Contact the Plan Provider Directly: Visit the provider's website or call their customer service to get more information and enroll.
- Use Medicare.gov: Compare plans and enroll directly through Medicare.gov.
FAQs about Medicare Special Needs Plans in El Paso County
What is a Medicare Special Needs Plan (SNP)?
A Medicare Special Needs Plan (SNP) is a type of Medicare Advantage Plan designed to meet the specific needs of individuals in El Paso County who have chronic conditions, live in long-term care facilities, or qualify for both Medicare and Medicaid.
How do SNPs differ from regular Medicare Advantage plans?
Unlike standard Medicare Advantage Plans, SNPs provide specialized benefits and care coordination tailored to individuals with unique healthcare needs, such as chronic illnesses or dual eligibility for Medicare and Medicaid.
Can I switch to an SNP if I’m already enrolled in a different Medicare plan?
Yes, switching to an SNP is possible during the Annual Enrollment Period (AEP) or during a Special Enrollment Period (SEP) if you qualify due to a life event, such as moving or losing coverage.
What types of chronic conditions qualify for a Chronic Condition SNP (C-SNP)?
If you have a chronic condition like diabetes, heart disease, or chronic obstructive pulmonary disease (COPD) and reside in El Paso County, you may qualify for a Chronic Condition SNP (C-SNP). Check the specific plan details to ensure coverage for your condition.
How do I find out if my doctors and medications are covered by an SNP?
You can verify whether your doctors and prescriptions are covered by reviewing the plan’s provider network and drug formulary. This information is usually available on the plan’s website or through customer service.
Can I enroll in an SNP at any time, or do I have to wait for an enrollment period?
Enrollment in an SNP in El Paso County is generally limited to specific periods, such as the Initial Enrollment Period (IEP), Annual Enrollment Period (AEP), or Medicare Advantage Open Enrollment Period (MA OEP). Special Enrollment Periods (SEPs) may also be available if you experience certain qualifying events.
Plan Availability
The D-SNP, C-SNP, and I-SNP plans on this page are available to qualifying individuals, enrolled in both Medicare Part A and B, living in Calhan, Cascade, Colorado Springs, Elbert, Fountain, Manitou Springs, Monument, Palmer Lake, Peyton, Usaf Academy, Yoder, and all other areas of El Paso County, Colorado.
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.