BlueJourney Alliance Special Needs Plans

Get customized coverage for your unique needs.

Capital Blue Medicare

BlueJourney Alliance Special Needs Plans (SNPs) are BlueJourney HMO plans that are designed exclusively for Medicare beneficiaries who meet certain eligibility criteria. These plans cater their benefits to serve the unique needs of their members.

BlueJourney Alliance offers two types of Special Needs Plans

  1. Institutional Special Needs Plan (ISNP)/ Institutional Equivalent Special Needs Plans (IE-SNPs) - restrict enrollment to MA eligible individuals who, for 90 days or longer, have had or are expected to need the level of services provided in a long-term care (LTC) skilled nursing facility (SNF), a LTC nursing facility (NF), a SNF/NF, an intermediate care facility for individuals with intellectual disabilities (ICF/IDD), or an inpatient psychiatric facility or people who, for 90 days or longer, have had or are expected to need institutionalized care, as determined by the state.
  2. Chronic Care Special Needs Plan (CSNP) – restrict enrollment to special needs individuals with specific severe or disabling chronic conditions.

Plan Type

Who’s Eligible

Which providers can I see?

Do I need a referral to see a specialist?

Institutional and Institutional-Equivalent Plans

People who live in skilled nursing facilities, and people who live in assisted living communities, and need the same kind of care as those who live in a skilled nursing facility.

You generally have to get your care and services from providers in the plan's network. Some plans do allow out-of-network coverage, but you might have to pay more for it.

Maybe, depending on the plan you have.

Chronic Condition Plans

 

People who have certain chronic conditions that are severe or disabling.

You generally have to get your care and services from providers in the plan's network. Some plans do allow out-of-network coverage, but you might have to pay more for it.

Maybe, depending on the plan you have.


To enroll in a Medicare Special Needs Plan, you must meet the following eligibility requirements:

  • Be enrolled in Medicare Part A and Part B.
  • Live in the service area of the Special Needs Plan.
  • Meet the eligibility requirements that the Special Needs Plan targets (i.e., live in an institution; have Medicare and Medicaid; or have the chronic condition(s) that the plan targets).

Updated October 1, 2018

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