Needs Plans (CSNP-DSNP) 2021
The three types of Special Needs Plans are: - Dual, Chronic Condition and
Institutional/Institutional-Equivalent.
When does the Special Election Period for Dual/LIS Change in Status begin for DSNP
members that lose Medicaid eligibility? - The month after they are notified by the plan of
the loss of Medicaid eligibility
A DSNP might be in the best interest of which of these consumers? - Joe, whose low income
qualifies him for full Medicaid coverage
Which program is available to support the unique health care needs of CSNP and DSNP
members? - A care management program that varies depending upon the level of the
member's health risk level
Which statement best describes a DSNP? - The monthly premium is at or below the Low
Income Subsidy benchmark to cover drug costs
When selling DSNPs, agents must: - 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
Which consumer may be a good candidate for a DSNP? - Anne, who does not pay a
percentage of charges when she receives medical care
Which of the following consumers is best suited for a CSNP? - Mary, who has been seeing a
specialist for a qualifying chronic condition
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? - During the Annual Election Period (AEP) or Open Enrollment Period (OEP)
Which is a service provided to a CSNP or DSNP member placed in the low to moderate care
management risk level? - Ongoing reassessment of risk level for status changes
What is the purpose of the Chronic Condition Verification form? - 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 CSNP.