Medicare Advantage

Have a Qualifying Diagnosis? Your Winston-Salem C-SNP Guide

Forsyth County has 97 Medicare Advantage plans for 2027. Compared with 2026, 15 plans are not coming back, 13 are new, and 41 continuing plans changed in some way you should check before December 7, 16 of them under a new name. This guide covers what those numbers mean for Winston-Salem, not which plan to pick.

Winston-Salem, N.C. — Fall 2026. As the Medicare Annual Enrollment Period opens Oct. 15 and runs through Dec. 7, 2026, people living with long-term health conditions in and around Winston-Salem have a specific kind of Medicare Advantage plan to consider: a Chronic Condition Special Needs Plan, or C-SNP. These plans are built around a qualifying diagnosis, and the 2027 lineup for Forsyth County — the county Winston-Salem sits in — includes 10 of them from seven carriers.

Here is what a C-SNP is, which ones will be sold locally for 2027, and the special sign-up window that comes with a qualifying condition.

What is a C-SNP, and how does it work in Winston-Salem?

A C-SNP is a type of Medicare Advantage plan that only enrolls people who have a specific chronic condition, such as diabetes or certain heart conditions. The plan's benefits, drug list and provider network are shaped around that condition.

Like other Medicare Advantage plans, a C-SNP replaces how you get Original Medicare (Parts A and B) and almost always includes Part D prescription drug coverage. The difference is the entry rule: you must have the qualifying diagnosis the plan is designed for, and your provider must confirm it on a form the plan sends. If your condition changes or the plan can no longer verify it, you can be moved out of the plan after a grace period.

In short: a C-SNP is not a separate program. It is a Medicare Advantage plan with a narrower front door and a care focus built around the people who walk through it.

How many C-SNPs are offered in Forsyth County for 2027?

For plan year 2027, Forsyth County has 10 C-SNPs out of 97 total Medicare Advantage plans. The other Special Needs Plans in the county break down as 23 Dual Eligible Special Needs Plans (D-SNPs), for people with both Medicare and Medicaid, and 8 Institutional Special Needs Plans (I-SNPs), for people who live in a nursing home or need that level of care.

Seven carriers are offering C-SNPs locally for 2027: Aetna (CVS Health), Alignment Health Plan, Devoted Health, HealthSpring, Humana, Liberty Medicare Advantage and UnitedHealthcare. The table below lists every plan.

Which C-SNPs will be sold in Winston-Salem for 2027?

In alphabetical order by carrier, the 10 C-SNPs available in Forsyth County for 2027 are:

• Aetna Medicare Chronic Care (HMO C-SNP) — Aetna (CVS Health); new for 2027.
• Alignment Health Heart & Diabetes 011 (HMO C-SNP) — Alignment Health Plan; renamed from Alignment Health Heart & Diabetes Care (HMO C-SNP).
• Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) — Alignment Health Plan; renamed from Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP).
• DEVOTED C-SNP ENHANCED 017 NC (HMO C-SNP) — Devoted Health; renamed from DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP).
• DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) — Devoted Health; new for 2027.
• DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) — Devoted Health.
• HealthSpring Achieve (HMO C-SNP) — HealthSpring; new for 2027.
• Humana Gold Plus - Diabetes and Heart (HMO C-SNP) — Humana.
• Liberty Medicare Advantage (HMO C-SNP) — Liberty Medicare Advantage.
• UHC Complete Care NC-28 (HMO-POS C-SNP) — UnitedHealthcare.

Some plan names mention the conditions they serve. Where a name does not say, do not assume — the plan's own documents and the Medicare Plan Finder show which diagnosis qualifies you to enroll.

Who qualifies, and how does a provider confirm the diagnosis?

To join a C-SNP, you must have the chronic condition the plan is approved to serve. After you apply, the plan asks your doctor or other treating provider to fill out a short form (sometimes called a Chronic Condition Verification form) that confirms the diagnosis.

If your provider confirms the condition, you are enrolled. If verification does not come back within the plan's deadline, the plan can end your enrollment. The chronic conditions that qualify for a C-SNP are set by Medicare and include conditions such as diabetes mellitus, chronic heart failure, cardiovascular disorders, chronic lung disorders, end-stage renal disease and several others. The specific list a given plan accepts is in that plan's materials.

Having a qualifying condition does not automatically enroll you. You still have to pick a plan, apply, and let the verification happen.

When can I enroll in a C-SNP in 2026 and 2027?

Two separate windows matter here.

First, the Annual Enrollment Period runs Oct. 15 through Dec. 7, 2026. Anything you choose during this window takes effect Jan. 1, 2027. If you do nothing, your current plan simply renews for 2027 if it is still offered, with any changes spelled out in the Annual Notice of Change (ANOC) your plan mailed in the fall.

Second, people with a qualifying chronic condition get a Special Enrollment Period (SEP) to join a C-SNP. That means you do not have to wait for Oct. 15–Dec. 7. You can enroll in a C-SNP once, outside the Annual Enrollment Period, when you first become eligible for one because of your diagnosis. If you later want to switch or leave, the regular Medicare rules (including the Medicare Advantage Open Enrollment Period from Jan. 1 to March 31) apply.

What is changing in Forsyth County's C-SNP lineup for 2027?

Three of the 10 C-SNPs offered in Forsyth County for 2027 are new: Aetna Medicare Chronic Care (HMO C-SNP), DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) and HealthSpring Achieve (HMO C-SNP). Three others are renamed versions of plans Alignment Health Plan and Devoted Health offered in 2026; a renamed plan is still a different contract, so it is worth reading the 2027 Evidence of Coverage even if the name feels familiar.

Across all Medicare Advantage plans in the county, 15 plans are not returning for 2027, 13 are new, and 16 are renamed. If you are already in a C-SNP, your plan's ANOC lists exactly what is changing for your 2027 coverage.

What else is changing in Medicare for 2027?

A few program-wide numbers are already set for 2027 and worth knowing before you compare plans:

• The Part D out-of-pocket cap rises to $2,400 in 2027 (up from $2,100 in 2026).
• The Part D maximum deductible is $700 in 2027 (up from $615 in 2026).
• The Part D national base beneficiary premium is $41.33 for 2027 — this is a formula input, not what any individual plan charges.
• The 2027 Part B standard premium and deductible, and the 2027 IRMAA income brackets, have not been announced yet. CMS usually publishes those in November.

The Medicare Prescription Payment Plan — the option to spread drug costs over the calendar year in monthly amounts — continues to be available.