MEDICARE SPECIAL NEEDS PLANS
Learn more about Special Needs Plans
A Special Needs Plan (SNP) is for customers with a range of special health care needs, including chronic illness. The list of SNP types are listed below.
- Dual SNP (D-SNP) for members with Medicare and Medicaid coverage
- Chronic SNP (C-SNP) for members with a chronic condition
- Institutional SNP (I-SNP) for members who live in a long-term care facility
Medicare, the Centers for Medicare & Medicaid Services (CMS), requires Special Needs Plans to provide care and services that meet their members’ health care needs. To do this, SNP plans must have a Model of Care (MOC) that describes how the plan meets the special health care needs of its customers. CMS (Medicare) reviews the plan’s MOC to make sure it will meet the needs of our members.
Cigna-HealthSpring has three (3) SNPs. Each SNP will give our customers a range of care and services:
- Benefits, including prescription drug coverage
- Case management programs
- Health care professionals
Cigna-HealthSpring Special Needs Plan includes:
- D-SNP for members with Medicare and Medicaid coverage
- C-SNP for members with Diabetes
- I-SNP for members who live in an Institutional or long-term care facility
Cigna-HealthSpring Special Needs Plans offer additional services to help meet your health care needs. This includes conducting a Health Risk Assessment, creating an Individualized Care Plan based on your health needs and having access to an Interdisciplinary Care Team that will help you manage your healthcare goals. The following describes services SNP members receive.
Health Risk Assessment
A Health Risk Assessment (HRA) is a questionnaire that helps identify your health care needs. You will get a Health Risk Assessment within 90 days of joining the plan and then yearly, within one year of your last completed assessment.
Individualized Care Plan
You will get an Individualized Care Plan based on the results of your Health Risk Assessment. The individualized care plan identifies health goals that you can work on with your care manager or primary care provider.
Interdisciplinary Care Teams
You will get support from a team of health care professionals that includes:
- Primary care physician
- Caregivers, as needed
- Network doctors and specialists, as needed
You may also get support from:
- Social workers
- Nurse Case Managers
Support from the health care professionals will be specific to your health care needs. We encourage you to participate in Interdisciplinary Care Team activity.
If you need to stay at a hospital or Skilled Nursing Facility, you will get help with your transition of care. These programs can:
- Connect you with the right doctors
- Coordinate communication between settings
- Help you learn more about self-care during and after your hospital stay
Case Management is a free, voluntary program that helps meet the special needs of customers with serious health conditions. A Case Management team is made of health care professionals such as:
- Health coaches
- Other staff
Your Case Management team will work behind the scenes or directly with you to:
- Help set up health care goals
- Meet your health care needs
- Improve your health
Learn more about Case Management and how to contact the Case Management department in your area.
To get the most out of your SNP plan, please complete an HRA annually. Review your Individualized Care Plan with your PCP and take an active role in your annual Interdisciplinary Care Team (ICT) meeting.
You may update or complete your Health Risk Assessment (HRA) in the way that meets your needs:
An HRA is available
- By calling us at 1-800-331-6769 (TTY 711) or
- On-line by selecting this link: https://www.cigna.com/medicare/medicare-advantage/health-risk-assessment.
- Once you have answered the questions online, please print and fax or mail to the address below.
- By Mail - If you received an HRA in the mail, complete and mail to us at:
- Cigna-HealthSpring, Attn: HRA Department
- 500 Great Circle Road
- Nashville, TN 37228
- Fax Number: 1-877-440-9340
Meet with your primary care physician for a routine physical.
- Tell your doctor how you feel
- Ask questions about your care plan
- Review your medicines to make sure you take them correctly
- Talk openly and honestly about any changes
Get your preventive screenings and annual vaccinations, like a flu shot.
- Cigna-HealthSpring sends reminders about preventive care services. Be sure to schedule your doctor visits as soon as you hear from us.
Ask for a copy of your care plan or discuss it with a member of the Cigna-HealthSpring team. For help, call the Case Management department in your area (Case Management contact information listed below).
Community Resource Unit - This team is dedicated to helping you get in touch with:
- Social resources
- Financial resources
- Safety resources
- Legal resources
Call 1-866-952-7593 (TTY 711), 8 am - 5 pm CST.
Getting ready to have a transition of care.
A transition of care can include an admission to the hospital. A trip to the hospital can be a very stressful and difficult time for you and your family. Be sure to talk with your primary health care professional or the doctor who arranged for your visit about what to do prior to your hospital stay. You may need to follow a special diet or prepare in other ways.
During your stay you will receive a lot of information on your condition from your physician and your health care team including information leading to your discharge.
As you prepare for your nursing facility or hospital stay and before you are discharged, you should think about:
- What support do you have at home from family, friends, and/or neighbors?
- How will you get dressed, showered, and move around your home?
- Do you have the necessary medical equipment to assist with your daily activities such as wheelchair, cane, rolling walker?
- How many steps do you have to get in your home and inside your home?
- How will you get your medications from the pharmacy?
- Who will help you prepare your meals and help with grocery shopping if needed?
- Who will pick you up when you are ready to go home?
- How will you get to your medical appointments?
If you think you will have difficulty in any of these areas, please let your health care team know so they can help. The Cigna-HealthSpring Case Management department and your hospital case manager can assist in finding solutions to make your discharge home as safe as possible.
For help, call the Case Management department in your area:
- Alabama, Atlanta, Florida, Southern Mississippi, North Carolina, South Carolina: 1-866-382-0518 (TTY 711)
- Georgia (except Atlanta), Northern Mississippi and Tennessee: 1-888-615-2709 (TTY 711)
- District of Columbia, Delaware, Maryland, Pennsylvania: 1-877-562-4395 (TTY 711)
- Arkansas, Oklahoma, Texas: 1-888-501-1116 (TTY 711)
- Arizona: 1-800-627-7534 (TTY 711)
Feeling a little under the weather?
Before going to the emergency room for routine care, call your primary health care professional’s office, or call Customer Service toll-free at 1-800-668-3813 (TTY 711), 7 days a week, 8 a.m. – 8 p.m. From April 1st – September 30th: Monday – Friday 8:00 am - 8:00 pm local time (messaging service used weekends, after hours, and Federal holidays).
You can also call the 24-hour Health Information Line at 1-855-784-5613 (TTY 711). Get answers to your health questions day or night.
Make sure that Cigna-HealthSpring can reach you:
- Call Customer Service at the number below.
For all other inquiries call Customer Service toll-free at 1-800-668-3813 (TTY 711), 7 days a week, 8 a.m. – 8 p.m. From April 1st – September 30th: Monday – Friday 8:00 am - 8:00 pm local time (messaging service used weekends, after hours, and Federal holidays). Esta información está disponible de forma gratuita en otros idiomas.
Cigna-HealthSpring has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 2019. NCQA’s approval is based on a review of Cigna-HealthSpring’s Model of Care and is an indicator of compliance with CMS requirements. NCQA’s approval is not an endorsement by CMS and/or NCQA of Cigna-HealthSpring or the quality of service provided by Cigna-HealthSpring. Cigna-HealthSpring will still need to be approved each year by CMS in order to operate. If you have questions regarding our approval by the NCQA, please contact our Customer Service Team at 1-800-668-3813 TTY 711.