SPECIAL NEEDS PLANS
Learn more about Special Needs Plans
A Medicare Advantage Special Needs Plan (SNP) is for customers with a range of special health care needs, including chronic illness. A document called a “Model of Care” must be filed with the Centers for Medicare & Medicaid Services (CMS) for every Special Needs Plan. The document describes how the plan meets the special health care needs of its customers.
Cigna-HealthSpring has three Special Needs Plans that give our customers a range of:
- Benefits, including prescription drug coverage
- Case management programs
- Health care professionals
A Cigna-HealthSpring Special Needs Plan may be right for you if you:
- Have Medicare and Medicaid
- Have a chronic condition such as:
- Congestive Heart Failure
- Live in a long-term care facility
Cigna-HealthSpring Special Needs Plans offer tools and resources to help meet your health care needs.
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.
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
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.
Update or complete your Health Risk Assessment in the way that meets your needs:
- Call the HRA Department at 1-800-331-6769 (TTY 711) or
- Access the form.
- Once you have answered the questions online, please print and mail or fax to:
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, such as a flu shot.
Cigna-HealthSpring will send you 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.
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 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: 1-866-382-05181-866-382-0518 (TTY 711)
- Georgia (except Atlanta), Northern Mississippi and Tennessee: 1-888-615-2709 (TTY 711)
- District of Columbia, Delaware, Maryland, Pennsylvania: 1-888-454-0013 Ext. 336351 (TTY 711)
- Illinois: 1-866-487-3002, Option 4 (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.
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. 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 2017. 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.