2021 United HealthCare Chronic Condition and Dual Special Needs Plans (CSNP-DSNP) Test already passed

2021 United HealthCare Chronic Condition and Dual Special Needs Plans (CSNP-DSNP) Test.Dual Special Needs Plans (DSNP) are defined as which of the following: - correct answer Medicare Advantage Plans uniquely designed for consumers enrolled in both Medicare and Medicaid Which statement is true about how loss of Medicaid affects a member's enrollment in a DSNP? - correct answer Special Election Period (SEP Dual/LIS Change in Status) is available for DSNP members that lose their Medicaid eligibility. Which consumer might benefit the most by enrolling in a DSNP? - correct answer Joe, who receives Qualified Medicaid Beneficiary benefits (QMB+) What program is available to support CSNP and DSNP members who may have unique health care needs? - correct answer A care management program that varies depending upon the level of the member's health risk level 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: - correct answer Selling DSNPs The consumer states they currently pay a percentage of charges when they receive medical care. This means: - correct answer The consumer is not likely to be a Full Dual-Eligible and may be better suited for enrollment in another type of plan. Which of the following consumer characteristics demonstrates a good fit for a CSNP? - correct answer A consumer with a qualifying chronic condition who wants a plan that will help them manage their illness and health care costs On July 19, each of the following consumers met with an agent. Based on the information provided, which consumer must wait until the Annual Election Period (AEP) or Open Enrollment Period (OEP) to enroll? - correct answer Joy has a cardiovascular disorder, is enrolled in a CSNP that covers the condition, and wants to enroll in another CSNP offered by the plan that covers the same condition. Which service will a CSNP or DSNP member in the high risk care management category receive? - correct answer Case Management (telephonic, digital and/or face-to-face) according to individual needs It is very important for consumers enrolling in a CSNP to know the following about accessing providers: - correct answer Some CSNPs are Preferred Provider Organization (PPO) or Point of Service (POS) Plans that allow members to see out-of-network providers, generally with higher cost sharing. Which statement is true about the Medicaid program? - correct answer It helps pay medical costs for certain groups of people with limited income and resources. You must advise consumers enrolling in a DSNP that: - correct answer They are not required to pay copayments for Medicare-covered services received from a DSNP network provider if they are Full Dual-Eligible or determined DSNP eligible by our plan agreement with the state in which they reside. Their provider should bill the state Medicaid program. Ginny just enrolled in a CSNP that uses the post-enrollment verification method. When will the plan send her a termination notification letter if it has not yet been able to verify a qualifying chronic condition? - correct answer At the end of her first month of enrollment A DSNP member loses his eligibility due to a change or loss of Medicaid status. What cost sharing is he responsible for while in the grace period? - correct answer All, such as premiums, deductibles, copayments, and coinsurance When does the Special Election Period for Dual/LIS Change in Status begin for DSNP members that lose Medicaid eligibility? - correct answer Upon notification or effective date of the loss, whichever is earlier Which statement is true about CSNPs, DSNPs, and prescription drug coverage? - correct answer CSNPs and DSNPs include Medicare Part D prescription drug coverage When selling DSNPs, agents must: - correct answer Confirm the consumer's Medicaid level and that the consumer is entitled to Medicare Part A and enrolled in Part B