Privacy Policy About Your Health Insurance Shop Directions Contact Us   Facebook  

Chronic Conditions

Medicare for those who are eligible for Medicare with Diabetes, Cardiac Problems, Arthritis and more.

As the baby boomer population is getting gradually older chronic illness is also on the rise.

Approximately 92% of older adults have at least one chronic disease, and 77% have at least two. Four chronic diseases—heart disease, cancer, stroke, and diabetes—cause almost two-thirds of all deaths each year.

Chronic diseases account for 75% of the money our nation spends on health care, yet only 1% of health dollars are spent on public efforts to improve overall health.

Diabetes affects 12.2 million Americans aged 60+, or 23% of the older population. An additional 57 million Americans aged 20+ have pre-diabetes, which increases a person's risk of developing type 2 diabetes, heart disease, and stroke.

Worldwide, the number of people living with diabetes has quadrupled since 1980, to more than 400 million, according to the World Health Organization (WHO).
90% of Americans aged 55+ are at risk for hypertension, or high blood pressure. Women are more likely than men to develop hypertension, with half of women aged 60+ and 77% of women aged 75+ having this condition. Hypertension affects 64% of men aged 75+.

How Did Medicare Respond?

In 2003, to deal with this growing health crisis in the aging population, the US Congress authorized the establishment of Chronic Condition Special Needs Plans, also known as C-SNPS.

Chronic Condition Special Needs Plans are Medicare Advantage Plans that restrict enrollment to individuals with specific severe or disabling chronic conditions. Approximately two-thirds of Medicare enrollees have multiple chronic conditions requiring coordination of care among primary providers, medical and mental health specialists, inpatient and outpatient facilities, and extensive ancillary services related to diagnostic testing and therapeutic management.
 
There are many advantages of participating in a Special Needs Plan, if you are diagnosed with one of the chronic conditions listed below.

Participants in Special Needs Plans receive personalized guidance and resources to help members get the right care and information, based on their specific condition or needs. In most cases the benefits are increased and there is greater access to resources and specialists who treat your specific condition.

Generally, there is more monitoring of your health status, co-pays may be lower or waved, there are longer benefit coverages for hospital stays and specialty medical services and more preventive health benefits like screenings and wellness programs are included.

Contact Your Health Insurance Shop to talk to a Licensed Insurance Agent in your area.

Specific Chronic Conditions for Medicare Special Needs Plans

  • Chronic alcohol and other drug dependence
  • Autoimmune disorders limited to:
    • Polyarteritis nodosa
    • Polymyalgia rheumatica
    • Polymyositis
    • Rheumatoid arthritis
    • Systemic lupus erythematosus
  •  Cancer, excluding pre-cancer conditions or in-situ status
  •  Cardiovascular disorders limited to:
    • Cardiac arrhythmias
    • Coronary artery disease
    • Peripheral vascular disease
    •  Chronic venous thromboemolic disorder
  • Chronic heart failure
  • Dementia
  • Diabetes mellitus
  • End-stage liver disease
  • End-stage renal disease (ESRD) requiring dialysis
  • Severe hematologic disorders limited to:
    • Aplastic anemia
    • Hemophilia
    • Immune thrombocytopenic purpura
    • Myelodysplastic syndrome
    • Sickle-cell disease (excluding sickle-cell trait)
  • HIV/AIDS
  •  Chronic lung disorders limited to:
    • Asthma
    • Chronic bronchitis
    • Emphysema
    • Pulmonary fibrosis
    • Pulmonary hypertension
  • Chronic and disabling mental health conditions limited to:
    • Bipolar disorders
    • Major depressive disorders
    • Paranoid disorder
    • Schizophrenia
    • Schizoaffective disorder
  • Neurologic disorders limited to:
    • Amyotrophic lateral sclerosis (ALS)
    • Epilepsy
    • Extensive paralysis (i.e., hemiplegia, quadriplegia, paraplegia, monoplegia)
    • Huntington's disease
    • Multiple sclerosis
    • Parkinson's disease
    • Polyneuropathy
    • Spinal stenosis
    • Stroke-related neurologic deficit
  • Stroke
  • Since many people have 2 or more chronic ailments at the same, there are also some groupings of common ailments such as
    • Diabetes mellitus and chronic heart failure
    • Chronic heart failure and cardiovascular disorders
    • Diabetes mellitus and cardiovascular disorders
    • Diabetes mellitus, chronic heart failure, and cardiovascular disorder
    • Stroke and cardiovascular disorder

If you think you may be eligible for a Chronic Condition Special Needs Plan through Medicare, talk to an insurance advisor at Your Health Insurance Shop. They'll tell you what you need to do to become eligible and help you weigh the benefits.

Contact Us

Return to Top

Critical Care Medicare Coverage in Pennsylvania

Plans for those who are eligible for Medicare

In addition to supplemental insurance for those who are eligible for Medicare, we offer a variety of products of interest.  These include:

Which is right for you? At Your Health Insurance Shop, we know your life situation is unique, and we're ready to help you find the solution that meets your needs and budget.

Contact us today to learn more.

 
health-insurance