Medicare Advantage

Does a Chronic Diagnosis Change Your Medicare Options?

People in Madison can choose from 48 Medicare Advantage plans for 2027, against 55 this year. Eleven of this year’s plans are gone, 4 are new to Dane County, and 31 that continue have changed their premium, deductible, plan type or name, 9 of them under a new name.

Madison, Wis. — Fall 2026 is the window when Medicare beneficiaries in Dane County look over what will change for 2027. For people managing a serious, long-term illness, one slice of the Medicare Advantage market deserves a closer look: Chronic Condition Special Needs Plans, or C-SNPs. In Dane County, two C-SNPs are on the 2027 landscape, both from UnitedHealthcare, and enrolling in one takes more than a signature — it takes a qualifying diagnosis your doctor confirms.

What is a C-SNP and how does it work in Madison for 2027?

A C-SNP is a Medicare Advantage plan designed for people living with a specific chronic condition, such as diabetes, heart failure or chronic lung disease. Like other Medicare Advantage plans, a C-SNP bundles Part A and Part B, and these two Dane County C-SNPs also include Part D drug coverage.

What makes a C-SNP different is who can join. Membership is limited to people with the qualifying condition the plan is built around, and the plan tailors its provider network, drug list and care coordination to that condition. The idea is that every member is managing a similar health situation, so the plan can be more focused than a general Advantage plan.

Which C-SNPs are offered in Dane County for 2027?

For 2027, Dane County — the county Madison sits in — has two C-SNPs on the CMS landscape, both from UnitedHealthcare:

• UHC Complete Care WI-1 (PPO C-SNP), with drug coverage
• UHC Complete Care WI-20 (HMO-POS C-SNP), with drug coverage

The table below lists every Medicare Advantage plan in the county, including these two. The plan names themselves do not state which chronic conditions they serve, so you will need to check each plan's materials on medicare.gov or call the carrier to see whether your diagnosis qualifies.

For context, C-SNPs are one of three kinds of Special Needs Plans. Dane County's 2027 lineup also includes 13 Dual Eligible SNPs (D-SNPs), for people with both Medicare and Medicaid, and 2 Institutional SNPs (I-SNPs), for people living in a nursing home or needing that level of care.

Who qualifies for a C-SNP, and how is the diagnosis confirmed?

To join a C-SNP, you must have the specific chronic condition the plan serves, and a provider has to confirm it. In practice, the plan will ask your doctor to verify your diagnosis — usually by signing a short form — before your enrollment is finalized. If the condition is not confirmed within the plan's timeframe, enrollment can be cancelled.

Medicare's rules list the chronic conditions that qualify a plan to be a C-SNP (examples include diabetes, cardiovascular disorders, chronic heart failure, chronic lung disorders, and end-stage renal disease, among others). Each plan picks the condition or conditions it serves, so being eligible for one C-SNP does not mean you are eligible for another.

When can I enroll in a C-SNP in Madison?

If you have a qualifying chronic condition, you get a Special Enrollment Period (SEP) to join a C-SNP. That means you are not locked into the regular Annual Enrollment Period of October 15 – December 7, 2026 — you can generally enroll in a C-SNP once you have the qualifying diagnosis, outside the usual windows.

A few timing notes to keep in mind for 2027:

• The Annual Enrollment Period runs October 15 – December 7, 2026, with any changes taking effect January 1, 2027.
• The Medicare Advantage Open Enrollment Period runs January 1 – March 31, 2027, for people already in a Medicare Advantage plan.
• If you do nothing, your current plan renews for 2027 if it is still offered, with the changes described in its Annual Notice of Change (ANOC).

What's changing across Dane County's Medicare Advantage lineup for 2027?

Zooming out from C-SNPs, Dane County's broader Medicare Advantage market is shifting modestly for 2027. Compared with 2026, 11 plans are not returning, 4 new plans are being added, and 9 plans are being renamed. The specifics for any plan you are in will be in that plan's ANOC, which arrives by late September.

Two Part D numbers are already confirmed for 2027 and worth knowing if you take prescriptions: the out-of-pocket drug cap rises to $2,400 (from $2,100 in 2026), and the maximum Part D deductible rises to $700 (from $615 in 2026). The 2027 Part B standard premium and deductible, along with the 2027 IRMAA income brackets, have not been announced yet; CMS typically publishes them in the fall.