How Do I Qualify and Enroll? - Members

To qualify for the Special Needs Plans (SNP) you must let us know that you have one of the chronic conditions that were discussed on the “Introduction” page or that you qualify for Medicare and Medicaid benefits.

Chronic Combined or Pulmonary SNP

You can qualify and enroll in one of these Plans at any time during the year. If you did not have one of these chronic conditions at the time of your initial enrollment, but do now, then you may qualify to change to one of these Plans.

Once you have requested enrollment in one of these Plans, Optimum will have to receive confirmation from one of your doctors that you do indeed have one of these conditions before your enrollment can be completed. You will receive an “Enrollment Qualification/Verification Form” with a return envelope to take with you to your doctor who will then confirm your diagnosis and return the form to the Plan.

 

Dual Eligible SNP

Dual eligible beneficiaries are classified as either full or partial dual eligible depending on your current income level and other qualifying criteria. 

Optimum will confirm your level of eligibility at the time of your request for enrollment, and will later receive confirmation of your actual level from Centers for Medicaid and Medicare Services (CMS) soon after enrollment. The information from CMS will be the deciding factor for your eligibility for this program.

If you are interested in joining one of these Plans or would like more information about the SNPs, please contact Member Services at 1-866-245-5360

 

Last Updated: 07/12/2018