Medicare Advantage Special Needs Plans are designed to provide targeted care and services to individuals with unique needs. The Generations Advantage Focus DC (HMO SNP) plan is a Chronic Condition Special Needs Plan (C-SNP) designed for Medicare-eligible people diagnosed with diabetes as a chronic or disabling condition. The plan provides complete medical, hospital, and Part D Prescription Drug coverage, with focused care and benefits for people living with diabetes in Cumberland County, Maine only. All benefits are for in-network services only, except urgent and emergency care.
The Special Needs Plan structured processes strive to meet the specialized needs of our members with a goal to optimize health outcomes. Care is coordinated by having a care manager as the point of contact who works in conjunction with the member’s primary care physician (PCP) and other interdisciplinary care team members. An interdisciplinary team can include but not is limited to caretakers, specialists, pharmacist, and community organizations. The model of care for this plan offers improved coordination and communication to ensure care is not fragmented and needed services are offered.
Mandatory Training for Network Providers
The plan’s Model of Care is a comprehensive plan to deliver coordinated, integrated care management for individuals with severe or disabling chronic conditions by promoting care management, quality, standards, and procedures. Through our contract with the Centers for Medicare and Medicaid Services (CMS) this plan requires providing mandatory Model of Care education to network providers upon admission to the SNP network and then annually.
Network providers can find an overview of the plan, its Model of Care, and the benefits your patients receive on the plan in our Model of Care training.
Model of Care training: This mandatory training provides an overview of the plan, its Model of Care, and the benefits your patients receive on the plan. The training is available here:
https://rise.articulate.com/share/4AdVEAmA5IOFKWE6-d4ndwkTiZd3cFT7#/
Attestation Form: Attest to your completed training by filling out our Special Needs Plans (SNP) Model of Care Training Attestation Form (PDF).
Our Commitment as a Health Plan: