Understanding Medicare Special Needs Plans in Henderson County, North Carolina
Explore 29 Medicare Special Needs Plans (SNPs) available in Henderson 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.
Ready to explore your Special Needs Plan options further? Speak with a licensed HealthCompare agent today at 1-833-748-3201 (TTY 711).
Compare the available plans below, or call 1-833-748-3201 (TTY 711) to speak with a licensed HealthCompare agent for personalized help.
An Overview of the Different SNP Plans in Henderson County
Not all SNPs are alike, and all types of plan are not available in all areas of North Carolina. These plans are crafted to meet the unique needs of different individuals. Each type of SNP focuses on providing specialized benefits to a particular group:
- Dual Eligible SNP Plans (D-SNP): Henderson offers 19 D-SNP plans. They combine Medicare and Medicaid benefits to simplify healthcare management. The average premium for these plans is $22.85. The premium on most D-SNP plans is covered in full by Medicaid.
- Chronic Condition SNP Plans (C-SNP): There are 4 C-SNP plans in Henderson County. The average premium for these plans is $0.00. C-SNPs provide specialized care for individuals with chronic health conditions.
- Institutional SNP Plans (I-SNP): Henderson County has 2 I-SNP plans available. These plans are designed for individuals living in long-term care facilities or those who require ongoing skilled nursing care.
- Medicare Advantage Plans: If you don't qualify for a SNP Plan or you can't find one that meets your needs, a traditional Medicare Advantage plan is another option. We organize these plans here: Medicare Advantage Plans in Henderson County, NC.
Dual Eligible Special Needs Plans (D-SNPs)
Tailored for individuals who qualify for both Medicare and Medicaid, these plans streamline your healthcare by combining benefits from both programs. You can also use the Medicare Plan Compare tool on Medicare.gov to explore your options further.
Henderson County, North Carolina D-SNP Options
| Plan Name | Rating* | Premium/Mo | Network | |
|---|---|---|---|---|
| Alignment Health NC Duals | $25 | HMO-POS D-SNP | ||
| Aetna Medicare Assure | $0 | HMO D-SNP | ||
| Cigna TotalCare | $41 | HMO D-SNP | ||
| Cigna TotalCare Plus | $0 | HMO D-SNP | ||
| Humana Dual Select H1036-307 | $51 | HMO D-SNP | ||
| Humana Gold Plus SNP-DE H1036-167 | $0 | HMO D-SNP | ||
| UHC Dual Complete NC-D001 | $51 | HMO-POS D-SNP | ||
| UHC Dual Complete NC-S3 | $0 | HMO-POS D-SNP | ||
| UHC Dual Complete NC-V001 | $51 | HMO-POS D-SNP | ||
| Healthy Blue + Medicare | $0 | HMO-POS D-SNP | ||
| Humana Dual Select H5525-072 | $46 | PPO D-SNP | ||
| Humana Dual Select H6622-027 | $51 | HMO-POS D-SNP | ||
| HumanaChoice SNP-DE H5525-036 | $0 | PPO D-SNP | ||
| Troy Medicare for Dual-eligible Beneficiaries | $0 | HMO D-SNP | ||
| UHC Dual Complete NC-S001 | $0 | PPO D-SNP | ||
| UHC Dual Complete NC-S2 | $0 | PPO D-SNP | ||
| Wellcare Dual Access | $43 | HMO-POS D-SNP | ||
| Wellcare Dual Reserve | $51 | HMO-POS D-SNP | ||
| Liberty Medicare Dual Plan | $24 | HMO D-SNP | ||
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- 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?
Institutional Special Needs Plans (I-SNPs)
These plans cater to individuals residing in long-term care facilities, such as nursing homes, or those requiring extended skilled nursing facility care at home. The CMS website provides more information about I-SNPs and their coverage details.
Henderson County, North Carolina I-SNP Options
| Plan Name | Rating* | Premium/Mo | Network | |
|---|---|---|---|---|
| UHC Nursing Home Plan NC-F001 | $51 | PPO I-SNP | ||
| Liberty Medicare Advantage Nursing Home Plan | $51 | HMO I-SNP | ||
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- 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?
Chronic Condition Special Needs Plans (C-SNPs)
These plans are tailored for individuals with significant or disabling chronic conditions. C-SNPs are focused on coordinating care across multiple medical providers and often offer additional benefits, such as prescription drug coverage.
Henderson County, North Carolina C-SNP Options
| Plan Name | Rating* | Premium/Mo | Network | |
|---|---|---|---|---|
| Alignment Health Heart & Diabetes | $0 | HMO-POS C-SNP | ||
| Humana Gold Plus - Diabetes and Heart | $0 | HMO C-SNP | ||
| UHC Complete Care NC-25 | $0 | HMO-POS C-SNP | ||
| Liberty Medicare Advantage | $0 | HMO C-SNP | ||
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | ||||
- 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?
How and When to Enroll in a Henderson County SNP Plan
If you’re considering enrolling in a Medicare Special Needs Plan (SNP) in Henderson County, it's important to be aware of the available enrollment periods. These windows allow you to choose or change your plan to fit your healthcare requirements.
When to Enroll
- Initial Enrollment Period (IEP): The IEP gives you your first chance to enroll in Medicare, starting three months before and ending three months after your 65th birthday. Learn more: Medicare Initial Enrollment Period Guide.
- Medicare Advantage Open Enrollment Period (MA OEP): Every year from January 1 to March 31, this period lets you switch your Medicare Advantage Plan, including SNPs, so long as you are currently enrolled in a Medicare Advantage plan. Learn more: MA Open Enrollment Guide.
- Annual Enrollment Period (AEP): This period runs from October 15 to December 7 and is when most people make adjustments to their Medicare coverage. Learn more: Medicare AEP Guide.
- Special Enrollment Periods (SEPs): If you have a qualifying life event, like moving or losing other coverage, you might qualify for a Special Enrollment Period. Learn more: SEP Guide.
How to Enroll
Ready to enroll in a Medicare Special Needs Plan? Here’s how to get started:
- Consult a Licensed Agent: Call 1-833-748-3201 (TTY 711) to speak with a licensed HealthCompare agent who can guide you through the process.
- Contact the Plan Provider Directly: Reach out to the plan provider via their website or customer service to begin enrollment.
- Use Medicare.gov: Visit Medicare.gov to compare plan options and enroll online.
Frequently Asked Questions about Medicare SNPs in Henderson County
What is a Medicare Special Needs Plan (SNP)?
A Medicare Special Needs Plan (SNP) is a type of Medicare Advantage Plan available to qualified individuals living in Henderson County with unique healthcare needs, such as those with chronic conditions, people living in long-term care facilities, or those who qualify for both Medicare and Medicaid.
How do SNPs differ from regular Medicare Advantage plans?
SNPs are tailored to meet specific healthcare needs, offering more targeted care and benefits than regular Medicare Advantage Plans. For example, a Chronic Condition SNP (C-SNP) is designed for individuals with chronic conditions, providing access to specialists and disease management programs.
Can I switch to an SNP if I’m already enrolled in a different Medicare plan?
Yes, you can switch to an SNP during certain enrollment periods, such as the Annual Enrollment Period (AEP) or a Special Enrollment Period (SEP) if you qualify.
What types of chronic conditions qualify for a Chronic Condition SNP (C-SNP)?
Chronic Condition SNPs (C-SNPs) are available in Henderson County for individuals with specific chronic conditions, such as diabetes, heart disease, or chronic obstructive pulmonary disease (COPD). Each plan may cover different conditions, so it's important to check the plan details.
How do I find out if my doctors and medications are covered by an SNP?
You can check a plan's provider network and formulary (list of covered drugs) through the plan’s website or by contacting the plan directly. You can also consult with a licensed insurance agent for assistance.
Can I enroll in an SNP at any time, or do I have to wait for an enrollment period?
Enrollment in a Special Needs Plan in Henderson County typically happens during specific enrollment periods, such as the Initial Enrollment Period (IEP), Annual Enrollment Period (AEP), or Medicare Advantage Open Enrollment Period (MA OEP) for Medicare beneficiaries currently enrolled in a Medicare Advantage plan. You may also qualify for a Special Enrollment Period (SEP) if you experience a qualifying life event.
The D-SNP, C-SNP, and I-SNP plans listed on this page are available to qualifying individuals enrolled in Medicare Part A and Part B living in East Flat Rock, Etowah, Flat Rock, Fletcher, Hendersonville, Horse Shoe, Mills River, Zirconia, and all other areas of Henderson County, North Carolina.
Plans Offered for Enrollment through Medicare.org
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.