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Navigate through the Enrollment Reasons plates until reaching the question:
”Are there any specific chronic conditions you have that may need additional coverage for, such as Diabetes, Heart Disease, Circulatory Disorder, Lung Disease, Auto Immune Disease, Neurological Disorder, or Mental Illness?”Skip this question and verify all other potential enrollment reasons first. If no other enrollment reason applies, place the customer on hole hold and verify there is a C-SNP in the area.
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Now that a C-SNP plan has been found, ask if they have any chronic conditions.
If yes, make sure their condition matches the conditions that the plan covers.
If no, this enrollment code may not be used.
Only one C-SNP code may be used per chronic condition per lifetime. Ask if they have used this chronic condition to enroll into a C-SNP in the past.
Set the expectation that Physician approval and documentation is needed. A physician must verify the Chronic Condition before the plan is approved.
You may now proceed with the enrollment.
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Enrollment Reasons
Plan | Code | Uses |
|---|---|---|
MA/MAPD/PDP | CSN | May only be used once per lifetime per chronic condition |
Medigap | N/A | Does not apply to Medigaps |
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