2023 UHC DSNP/CSNP QUESTIONS AND ANSWERS

Which statement is true of D-SNP members? - Members who are QMB+ or are Full Dual Eligible are not required to pay copayments for Medicare-covered services obtained from a D-SNP in-network provider. Their provider should bill the state Medicaid program, as appropriate, for these costs. Which service will a C-SNP or D-SNP member in the high risk care management category receive? - Case Management (telephonic, digital and/or face-to-face) according to individual needs John, 68, is currently enrolled in a Medicare Supplement Plan with a stand-alone Prescription Drug Plan. Newly diagnosed with a chronic condition, he calls agent Charles on May 3 to ask if there are plans that will help him manage his condition. Can John enroll in a C-SNP that covers his chronic condition? - Yes, he can enroll using his SEP (SEP-Special Need/Chronic) Which of the following consumers is best suited for a C-SNP? - Mary, who has been seeing a specialist for a qualifying chronic condition The consumer states they currently pay a percentage of charges when they receive medical care. This means: - The consumer is not likely to be a Full Dual-Eligible and may be better suited for enrollment in another type of plan When does the SEP for Dual/LIS Change in Status begin for D-SNP members that lose Medicaid eligibility? - Upon notification or effective date of the loss, whichever is earlier Alice is Full Dual Eligible and is enrolling in a D-SNP. What should her agent remind her about? - She is not required to pay copayments for Medicare-covered services when she uses a provider in the D-SNP network because she is Full Dual Eligible. Her provider should bill that state Medicaid program, as appropriate, for these costs. Which statement is true about provider information on the Chronic Condition Verification form? - The provider indicated on the form does not have to be contracted with the plan