Understanding Medicare Special Needs Plans in Clay County, Illinois
Explore 1 Medicare Special Needs Plans (SNPs) available in Clay 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).
Review your plan options below, or for personalized help, call 1-833-748-3201 (TTY 711) to connect with a licensed HealthCompare agent.
Types of Medicare Special Needs Plans in Clay County
Medicare Special Needs Plans (SNPs) are customized to address various healthcare needs. There are different types of SNPs, each created to offer tailored benefits for specific groups of individuals, but some areas of Illinois will not have all plan types:
- Chronic Condition SNP Plans (C-SNP): There are 1 C-SNP plans in Clay County. The average premium for these plans is $22.80. C-SNPs provide specialized care for individuals with chronic health conditions.
- Medicare Advantage Plans: If you don’t qualify for an SNP Plan or can’t find one that meets your needs, a traditional Medicare Advantage plan is another option. Browse them here: Medicare Advantage Plans in Clay County, IL .
Chronic Condition SNP Plans (C-SNP)
These plans are designed for individuals with severe or disabling chronic conditions. C-SNPs excel at coordinating your care among different medical specialists and often include extra benefits like prescription drug plans.
| Plan Name | Rating* | Premium/Mo | Network |
|---|---|---|---|
| UHC Complete Care Support IL-1A | $23 | PPO C-SNP | |
| * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. | |||
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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?
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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?
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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?
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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?
Enrolling in a Medicare Special Needs Plan (SNP) in Clay County involves understanding the different enrollment periods. Whether you're new to Medicare or want to change your current coverage, knowing when and how to enroll is key to getting the right plan for your health needs.
When to Enroll
- Initial Enrollment Period (IEP): Starting three months before your 65th birthday and lasting until three months after, this is your first chance to enroll in Medicare. Learn more: Medicare IEP Guide.
- Medicare Advantage Open Enrollment Period (MA OEP): Between January 1 and March 31, you can switch your Medicare Advantage Plan, including SNPs, so long as you are currently enrolled in a Medicare Advantage plan. Learn more: MA OEP Guide.
- Annual Enrollment Period (AEP): From October 15 to December 7, this period allows most people to adjust their Medicare plans. Learn more: AEP Guide.
- Special Enrollment Periods (SEPs): If you qualify due to certain life events, such as moving or losing other coverage, you may be eligible for a Special Enrollment Period. Learn more: SEP Guide.
How to Enroll
To enroll in a Medicare Special Needs Plan, you have several options:
- Consult a Licensed Agent: For personalized help, contact a licensed HealthCompare agent at 1-833-748-3201 (TTY 711).
- Contact the Plan Provider Directly: Visit the provider's website or call their customer service to get more information and enroll.
- Use Medicare.gov: Compare plans and enroll directly through Medicare.gov.
What is a Medicare Special Needs Plan (SNP)?
A Medicare Special Needs Plan (SNP) is a type of Medicare Advantage Plan designed to meet the specific needs of individuals in Clay County who have chronic conditions, live in long-term care facilities, or qualify for both Medicare and Medicaid.
How do SNPs differ from regular Medicare Advantage plans?
Unlike standard Medicare Advantage Plans, SNPs provide specialized benefits and care coordination tailored to individuals with unique healthcare needs, such as chronic illnesses or dual eligibility for Medicare and Medicaid.
Can I switch to an SNP if I’m already enrolled in a different Medicare plan?
Yes, switching to an SNP is possible during the Annual Enrollment Period (AEP) or during a Special Enrollment Period (SEP) if you qualify due to a life event, such as moving or losing coverage.
What types of chronic conditions qualify for a Chronic Condition SNP (C-SNP)?
If you have a chronic condition like diabetes, heart disease, or chronic obstructive pulmonary disease (COPD) and reside in Clay County, you may qualify for a Chronic Condition SNP (C-SNP). Check the specific plan details to ensure coverage for your condition.
How do I find out if my doctors and medications are covered by an SNP?
You can verify whether your doctors and prescriptions are covered by reviewing the plan’s provider network and drug formulary. This information is usually available on the plan’s website or through customer service.
Can I enroll in an SNP at any time, or do I have to wait for an enrollment period?
Enrollment in an SNP in Clay County is generally limited to specific 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. Special Enrollment Periods (SEPs) may also be available if you experience certain qualifying events.
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 Clay City, Flora, Louisville, Xenia, and all other areas of Clay County, Illinois.
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.
CMS Plan IDs Presented
The Medicare Special Needs Plan pages listed in the tables above include localization to assist beneficiaries with plans available in their service area. However, most Part C plans are available in more than one service area, which can lead to confusion. The following list of CMS IDs links to our master plan pages without localization.
- Medicare.gov, Special Needs Plans (SNP), Last Accessed May 5, 2025
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed 24 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage", Last Accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You", Last Accessed 22 May, 2025
- CMS.gov, Chronic Condition Special Needs Plans (C-SNPs), Last Accessed May 24, 2025
- CMS.gov, Landscape Source Files, Last Accessed March 15, 2025