How Long Do Plans Using The Csnp Pre Enrollment Verification Process

Question: The three types of Special Needs Plans are:

Answer: Dual, Chronic Condition and Institutional/Institutional-Equivalent.

Question: When does the Special Election Period for Dual/LIS Change in Status begin for DSNP members that lose Medicaid eligibility?

Answer: The month after they are notified by the plan of the loss of Medicaid eligibility

Question: A DSNP might be in the best interest of which of these consumers?

Answer: Joe, whose low income qualifies him for full Medicaid coverage

Question: Which program is available to support the unique health care needs of CSNP and DSNP members?

Answer: A care management program that varies depending upon the level of the member’s health risk level

Question: Which statement best describes a DSNP?

Answer: The monthly premium is at or below the Low Income Subsidy benchmark to cover drug costs

Question: When selling DSNPs, agents must:

Answer: Ensure that the consumer only has Medicare

Confirm the consumer’s Medicaid level and that the consumer is entitled to Medicare Part A and enrolled in Part B

Question: Which consumer may be a good candidate for a DSNP?

Answer: Anne, who does not pay a percentage of charges when she receives medical care

Question: Which of the following consumers is best suited for a CSNP?

Answer: Mary, who has been seeing a specialist for a qualifying chronic condition

Question: On May 10, Michael meets with an agent and says he is enrolled in another carrier’s CSNP due to his diabetes. When can Michael enroll in a different CSNP that also covers diabetes (his only chronic condition), assuming he has not moved out of his current plan’s service area?

Answer: During the Annual Election Period (AEP) or Open Enrollment Period (OEP)

Question: Which is a service provided to a CSNP or DSNP member placed in the low to moderate care management risk level?

Answer: Ongoing reassessment of risk level for status changes