Medicare Advantage

Do You Have Diabetes or Heart Disease? See C-SNPs

People in Philadelphia can choose from 98 Medicare Advantage plans for 2027, against 97 this year. Twelve of this year’s plans are gone, 13 are new to Philadelphia County, and 39 that continue have changed their premium, deductible, plan type or name, 9 of them under a new name.

PHILADELPHIA — If you live with a long-term health condition like diabetes or heart failure, there is a corner of Medicare built for you. For plan year 2027, eight Chronic Condition Special Needs Plans (C-SNPs) will be sold in Philadelphia County, and people who qualify can switch into one without waiting for the regular fall window.

The 2027 lineup is set, and Annual Enrollment runs Oct. 15 – Dec. 7, 2026 for coverage that starts Jan. 1, 2027. But a C-SNP comes with its own enrollment rules, which is why it is worth understanding before you shop.

What a C-SNP actually is

A Chronic Condition Special Needs Plan is a Medicare Advantage plan with a narrow door. Only people with a specific qualifying chronic condition — a short list set by CMS that includes conditions such as diabetes, chronic heart failure, cardiovascular disorders, chronic lung disorders and end-stage renal disease — can enroll.

Because the plan knows every member shares a condition, it is designed around that condition. Like other Medicare Advantage plans, a C-SNP covers everything Original Medicare covers, and every C-SNP in Philadelphia County for 2027 includes Part D prescription drug coverage. The plan tailors its provider network, drug list and care coordination to the condition it serves.

Costs, benefits, networks and drug lists vary from plan to plan. For specifics on any plan listed here, use the Medicare Plan Finder at medicare.gov, call 1-800-MEDICARE, or read the plan's Evidence of Coverage.

The 2027 C-SNPs in Philadelphia County

Philadelphia is in Philadelphia County, and Medicare plan availability is set at the county level. For 2027, CMS lists 8 C-SNPs in the county, out of 98 Medicare Advantage plans overall. The county also has 20 Dual Eligible SNPs (D-SNPs, for people with both Medicare and Medicaid) and 7 Institutional SNPs (I-SNPs), which serve different groups.

The eight C-SNPs for 2027, in alphabetical order by carrier:

• Aetna Medicare Chronic Care Value (HMO C-SNP) — Aetna (CVS Health)
• DEVOTED C-SNP ENHANCED 016 PA (HMO C-SNP) — Devoted Health (renamed; was DEVOTED C-SNP PREMIUM 016 PA)
• DEVOTED C-SNP GIVEBACK EXTRAS 027 PA (HMO C-SNP) — Devoted Health (new for 2027)
• DEVOTED C-SNP PLUS 021 PA (HMO C-SNP) — Devoted Health
• HealthSpring Achieve (HMO C-SNP) — HealthSpring
• HumanaChoice - Diabetes and Heart (PPO C-SNP) — Humana (new for 2027)
• UHC Complete Care PA-17 (HMO-POS C-SNP) — UnitedHealthcare
• UHC Complete Care Support PA-1A (HMO-POS C-SNP) — UnitedHealthcare (new for 2027)

The table below lists every plan in the county. A C-SNP's name does not always tell you which condition it covers; the Humana plan names diabetes and heart conditions, but for the others you will need to check the plan's materials to see which qualifying diagnosis it accepts.

How enrollment works — and the diagnosis step

Joining a C-SNP has one extra step compared with a regular Medicare Advantage plan: the plan must confirm your qualifying chronic condition with your doctor or other provider. Usually the plan sends a short form for your provider to sign. If the provider does not confirm the diagnosis within the window CMS allows, the plan cannot keep you enrolled.

That is why it helps to call your provider's office before you apply, so the paperwork does not stall.

The Special Enrollment Period for a qualifying condition

Most people can only change Medicare Advantage plans during set windows — the Annual Enrollment Period (Oct. 15 – Dec. 7) or the Medicare Advantage Open Enrollment Period (Jan. 1 – March 31).

People with a qualifying chronic condition have an extra option. CMS gives them a Special Enrollment Period to join a C-SNP that covers their condition, outside the normal windows. You can use it once per SEP; after you enroll in the C-SNP, the SEP ends. If you later lose eligibility — for example, the plan can no longer verify the diagnosis — you get a separate SEP to switch to another plan.

Practically, that means you do not have to wait until next October to move into a C-SNP. If a 2027 C-SNP fits your situation, you can act when you are ready.

What to compare before you choose

Because every C-SNP is built around one condition, the shopping questions are a bit different:

• Does the plan accept your specific diagnosis? Ask the plan directly.
• Are your doctors and your preferred hospitals in the plan's network?
• Are the medications you take on the plan's formulary, and in which tier?
• What is the plan's rule for seeing specialists, and does it coordinate care through a case manager?
• What are the monthly premium, deductible, copays and out-of-pocket maximum for 2027?

For 2027, Part D has an out-of-pocket cap of $2,400 (up from $2,100 in 2026), and the Part D maximum deductible is $700 (up from $615 in 2026). The 2027 Part B standard premium and deductible, and the 2027 IRMAA brackets, have not yet been announced; CMS typically publishes them in the fall.

If you do nothing

If you are already in a Medicare Advantage plan — including a C-SNP — and it is offered again next year, you stay enrolled and your coverage renews on Jan. 1, 2027 with the changes described in the plan's Annual Notice of Change (ANOC). Across Philadelphia County, 12 Medicare Advantage plans are not returning for 2027, 13 are new, and 9 have been renamed, so it is worth reading the ANOC that arrives by late September.