K
C
2025 DUAL ELIGIBLE AND
LO
CHRONIC CONDITION
SPECIAL NEEDS PLANS
YC
(D-SNP/C-SNP) ASSESSMENT
(UHC) EXAM STUDY GUIDE
D
QUESTIONS WITH CORRECT
U
ANSWERS ALL VERIFIED BY
ST
AN EXPERT A+ GRADED
(LATEST UPDATE)
, What are Dual Eligible Special Needs Plans (D-SNP)? - ANS Medicare Advantage Plans
uniquely designed for consumers enrolled in both Medicare and Medicaid.
Which statement is true about how the loss of Medicaid affects a member's enrollment in a
D-SNP? - ANS Special Election Period (SEP Dual/LIS Change in Status) is available for
D-SNP members and they will be responsible for all cost sharing.
D-SNP benefits are designed for the consumer who______________. - ANS Is enrolled in
their state Medicaid program, typically as a Full Dual, with their Medicare cost sharing paid by
the state in which they reside.
K
Which program is available to support the unique health care needs of C-SNP and D-SNP
members? - ANS A Care Management program that varies depending upon the level of the
C
member's health risk
Select the statement that best describes a feature of D-SNPs. - ANS D-SNPs are
LO
network-based.
Confirming the consumer's Medicaid level and that the consumer is entitled to Medicare Part A
and enrolled in Medicare Part B is a requirement of: - ANS Selling DSNPs
YC
The consumer states they currently pay a percentage of charges when they receive medical
care. This means: - ANS The consumer is not likely to be a Full Dual-Eligible and may be
better suited for enrollment in a type of plan other than a D-SNP.
Which Medicare-eligible consumer is best suited for a C-SNP? - ANS Mary, who has been
seeing a specialist for a qualifying chronic condition
D
Which two consumers can use the Special Election Period "SEP-Special Need/Chronic"?
(Select 2) - ANS Mark, currently enrolled in a Medicare Supplement Plan and a stand-alone
U
Prescription Drug Plan, was just diagnosed with a cardiovascular disorder and would like to
enroll in a C-SNP that covers the condition.
Thu is enrolled in a C-SNP that only covers diabetes. Newly diagnosed with a cardiovascular
ST
disorder, she wants to enroll in a C-SNP that covers her new condition.
Which of the following are Care Management Plan components provided to a C-SNP or D-SNP
member placed in the low to moderate Care Management risk level? - ANS All of the
responses are correct.
The Chronic Condition Verification form/questions authorizes the plan to do what? - ANS It
authorizes the plan to contact the provider identified on the form in order to verify that the
consumer has at least one of the qualifying chronic conditions covered by the C-SNP.
Which statement is true about the Medicaid program? - ANS Benefits vary from state to state.
C
2025 DUAL ELIGIBLE AND
LO
CHRONIC CONDITION
SPECIAL NEEDS PLANS
YC
(D-SNP/C-SNP) ASSESSMENT
(UHC) EXAM STUDY GUIDE
D
QUESTIONS WITH CORRECT
U
ANSWERS ALL VERIFIED BY
ST
AN EXPERT A+ GRADED
(LATEST UPDATE)
, What are Dual Eligible Special Needs Plans (D-SNP)? - ANS Medicare Advantage Plans
uniquely designed for consumers enrolled in both Medicare and Medicaid.
Which statement is true about how the loss of Medicaid affects a member's enrollment in a
D-SNP? - ANS Special Election Period (SEP Dual/LIS Change in Status) is available for
D-SNP members and they will be responsible for all cost sharing.
D-SNP benefits are designed for the consumer who______________. - ANS Is enrolled in
their state Medicaid program, typically as a Full Dual, with their Medicare cost sharing paid by
the state in which they reside.
K
Which program is available to support the unique health care needs of C-SNP and D-SNP
members? - ANS A Care Management program that varies depending upon the level of the
C
member's health risk
Select the statement that best describes a feature of D-SNPs. - ANS D-SNPs are
LO
network-based.
Confirming the consumer's Medicaid level and that the consumer is entitled to Medicare Part A
and enrolled in Medicare Part B is a requirement of: - ANS Selling DSNPs
YC
The consumer states they currently pay a percentage of charges when they receive medical
care. This means: - ANS The consumer is not likely to be a Full Dual-Eligible and may be
better suited for enrollment in a type of plan other than a D-SNP.
Which Medicare-eligible consumer is best suited for a C-SNP? - ANS Mary, who has been
seeing a specialist for a qualifying chronic condition
D
Which two consumers can use the Special Election Period "SEP-Special Need/Chronic"?
(Select 2) - ANS Mark, currently enrolled in a Medicare Supplement Plan and a stand-alone
U
Prescription Drug Plan, was just diagnosed with a cardiovascular disorder and would like to
enroll in a C-SNP that covers the condition.
Thu is enrolled in a C-SNP that only covers diabetes. Newly diagnosed with a cardiovascular
ST
disorder, she wants to enroll in a C-SNP that covers her new condition.
Which of the following are Care Management Plan components provided to a C-SNP or D-SNP
member placed in the low to moderate Care Management risk level? - ANS All of the
responses are correct.
The Chronic Condition Verification form/questions authorizes the plan to do what? - ANS It
authorizes the plan to contact the provider identified on the form in order to verify that the
consumer has at least one of the qualifying chronic conditions covered by the C-SNP.
Which statement is true about the Medicaid program? - ANS Benefits vary from state to state.
