Lesson 4b: (SNPs) Specials Needs Plans and Medicaid
Questions with Correct Answers
(SNP) Special Needs Plan Types Correct Answer-Chronic Special
Needs Plan (C-SNP)
Dual-Eligible Special Needs Plan (D-SNP)
Most SNPs are offered as HMO plans (in-network benefits)
Clients must meet certain qualifications to get a SNP (not available to all
Medicare recipients)
SNPs are NOT available in all geographical locations (there must be an
available plan in the client's area that matches their qualifications)
SNPs must go above and beyond regular MA plans and have extra
benefits (transportation, OTC, fitness, DVH, etc.)
Chronic Special Needs Plan (C-SNP) Correct Answer-We sell Humana,
Cigna, and United Healthcare C-SNPs
These plans are only offered in certain geographical areas of the United
States (see Quote Engine to check if SNP is applicable in their area)
CMS rules allow sales agents to ask client if the presentation of a C-SNP
is relevant to them
Agent CANNOT ask specifically if client has a qualifying Chronic
Condition
"I have a plan specifically for someone with diabetes, does that sound
like something you are interested in?"
Clients that have qualifying chronic condition(s) have an Election Period
to get enrolled into a C-SNP (upon diagnosis of condition or upon
joining one of these plans for the 1st time)
, *Get doctor's name and number upfront for all C-SNPs before sending
to enroller*
Chronic Conditions Include: Correct Answer-Diabetes Mellitus: A
disease marked by high levels of sugar in the blood. It can be caused by
too little insulin, resistance to insulin, or both
Chronic Heart Failure: A condition that happens when the heart cannot
pump blood to the rest of the body as well as it should
Chronic Lung Disorders and Cardiovascular Disease: Chronic conditions
of Asthma, Chronic Bronchitis, Emphysema, Pulmonary Fibrosis, and
Pulmonary Hypertension
End Stage Renal Disease (ESRD): When kidneys are no longer able to
work at a level needed for day-to-day life. (Most common causes of
ESRD are diabetes and high blood pressure)
Client only has to have 1 of these conditions to qualify for a C-SNP
available in their area
If a client is eligible for 2 C-SNPs in their service area, they can enroll in
the plan they want
Some states have combination C-SNPs (client only has to have 1 or
more qualifying conditions to be eligible for the plan)
Humana's Diabetes C-SNPs Correct Answer-Mandatory Supplemental
Benefits (MSBs):
Over-the-Counter Benefit: Includes new items specific to the diabetic
population (ex: compression socks)
Specialized Silver Sneakers: Well-being session and an exercise kit
Questions with Correct Answers
(SNP) Special Needs Plan Types Correct Answer-Chronic Special
Needs Plan (C-SNP)
Dual-Eligible Special Needs Plan (D-SNP)
Most SNPs are offered as HMO plans (in-network benefits)
Clients must meet certain qualifications to get a SNP (not available to all
Medicare recipients)
SNPs are NOT available in all geographical locations (there must be an
available plan in the client's area that matches their qualifications)
SNPs must go above and beyond regular MA plans and have extra
benefits (transportation, OTC, fitness, DVH, etc.)
Chronic Special Needs Plan (C-SNP) Correct Answer-We sell Humana,
Cigna, and United Healthcare C-SNPs
These plans are only offered in certain geographical areas of the United
States (see Quote Engine to check if SNP is applicable in their area)
CMS rules allow sales agents to ask client if the presentation of a C-SNP
is relevant to them
Agent CANNOT ask specifically if client has a qualifying Chronic
Condition
"I have a plan specifically for someone with diabetes, does that sound
like something you are interested in?"
Clients that have qualifying chronic condition(s) have an Election Period
to get enrolled into a C-SNP (upon diagnosis of condition or upon
joining one of these plans for the 1st time)
, *Get doctor's name and number upfront for all C-SNPs before sending
to enroller*
Chronic Conditions Include: Correct Answer-Diabetes Mellitus: A
disease marked by high levels of sugar in the blood. It can be caused by
too little insulin, resistance to insulin, or both
Chronic Heart Failure: A condition that happens when the heart cannot
pump blood to the rest of the body as well as it should
Chronic Lung Disorders and Cardiovascular Disease: Chronic conditions
of Asthma, Chronic Bronchitis, Emphysema, Pulmonary Fibrosis, and
Pulmonary Hypertension
End Stage Renal Disease (ESRD): When kidneys are no longer able to
work at a level needed for day-to-day life. (Most common causes of
ESRD are diabetes and high blood pressure)
Client only has to have 1 of these conditions to qualify for a C-SNP
available in their area
If a client is eligible for 2 C-SNPs in their service area, they can enroll in
the plan they want
Some states have combination C-SNPs (client only has to have 1 or
more qualifying conditions to be eligible for the plan)
Humana's Diabetes C-SNPs Correct Answer-Mandatory Supplemental
Benefits (MSBs):
Over-the-Counter Benefit: Includes new items specific to the diabetic
population (ex: compression socks)
Specialized Silver Sneakers: Well-being session and an exercise kit
