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Special Needs Plan

Illinois seniors suffering from a debilitating chronic health condition may qualify to enroll in a Medicare-approved Special Needs Plan. These different plans provide additional benefits above and beyond Medicare, offering seniors special healthcare and services.

Special Needs

Treatment of certain chronic health conditions such as cancer or dementia may require additional services above and beyond that which Medicare provides. For many seniors, the extra cost associated with treatment is a burden and Special Needs Plans address these concerns. Most benefits provided are paid in full for recipients who are enrolled in both Medicare and Medicaid. However, for seniors who do not qualify for Medicaid, participating in the plan costs about the same as enrollment in a typical Part C plan.

Eligibility

You must be enrolled in Medicare Part A and B, reside in the plan’s service area, and meet specific health requirements. Seniors with a disabling chronic condition or who live in a nursing home, require in-home care or currently receive both Medicare and Medicaid benefits may qualify. Plans may not be available in all states as insurance companies providing benefits decide which counties will offer plans.

Qualifying Conditions

You must have one or more of the following conditions:

Alcohol or drug dependence

Hematologic disorder

Autoimmune disorder

HIV/Aids

Cancer

Chronic lung disorder

Cardiovascular disorder

Disabling mental health conditions

Chronic heart failure

Neurologic disorder

Dementia

Stroke

Diabetes

End-stage liver disease

 

A Special Needs Plan may be the right choice, with an increased network of providers who specialize in treating your condition and providing additional benefits.

 

 

 

 

 

 

 

 

 

References:

https://www.medicare.gov/sign-up-change-plans/medicare-health-plans/medicare-advantage-plans/special-needs-plans.html

https://www.medicare.gov/Pubs/pdf/11302.pdf

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