Application Submission Information
Depending on the services, a prior authorization or referral from your doctor may be required.
For Chronic Special Needs Plans (SNP): These plans are available to anyone with Medicare who has been diagnosed with Diabetes, Cardiovascular Disease, Chronic Heart Failure, or a qualified Chronic Lung Disorder, such as Chronic Obstructive Pulmonary Disease (COPD), Asthma, Chronic Bronchitis, Emphysema, Pulmonary Fibrosis, or Pulmonary Hypertension.
For Dual Special Needs Plans (DSNP): These plans are available to anyone who has both medical assistance from the state and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. The Part B premium is covered for full dual members of Special Needs Plans.
Freedom Health, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Freedom Health, Inc. cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Español (Spanish): ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-401-2740 (TTY: 711). Kreyòl Ayisyen (French Creole): ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-800-401-2740 (TTY: 711).