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Plans for Individuals with Chronic Conditions

Optimum HealthCare offers Special Needs Plans (SNPs) for members who have certain chronic diseases. Individual Care Plans are developed for the SNP members to assist in the management of key chronic diseases. When you join a Medicare SNP, you get all of your Medicare hospital and medical health care services through that plan, including Medicare prescription drug coverage.  Use our Plan Finder to learn more about availability in your county and other plan-specific information.
 

Optimum Diamond Rewards (HMO POS SNP)

Plan ID: 28, 30

  • $0 Deductible
  • $97.10 Part B Reduction
  • $0 PCP Co-pay
  • $0 Tier 1 Drug Co-pay
  • Transportation Benefit (4 one-way trips: $0)
  • OTC ($30)
  • POS Benefit for Specialist visits
  • Vision, Dental, Hearing, Fitness and more
  • Eligibility Requirement: Chronic Heart Failure (CHF), Cardio Vascular Disease (CVD), and Diabetes Mellitus

Optimum Diamond Rewards COPD (HMO POS SNP)

Plan ID: 29,31

  • $0 Deductible
  • $97.10 Part B Reduction
  • $0 PCP Co-pay
  • $0 Tier 1 Drug Co-pay
  • Transportation Benefit (4 one-way trips: $0)
  • OTC ($30)
  • POS Benefit for Specialist visits
  • Vision, Dental, Hearing, Fitness and more
  • Eligibility Requirement: Chronic Obstructive Pulmonary Disease (COPD)

 To review plans for your area – click Plan Finder

Disclaimer

You must continue to pay your Medicare Part “B” Premium. The Part “B” Premium is covered for full dual members of Special Needs Plans.  Medicare approved Dual Eligible Special Needs Plans (SNPs) are available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. To qualify for a Chronic Condition SNP, physician diagnosis of the disease must be verified prior to confirmation of enrollment. People who do not have the condition will be disenrolled. If you lose eligibility or there are changes to your eligibility (or qualifying conditions) you will be disenrolled from the special needs plan. However, you will be eligible for a Special Election Period that will enable you to enroll in another plan. Benefits vary by Plan and County.  Limitations, Co-Pays and restrictions may apply.