2022 Chronic Condition and Dual Special Needs Plans (CSNP-DSNP) Test

Dual Special Needs Plans (DSNP) are defined as which of the following: - Answer- Medicare Advantage Plans uniquely designed for consumers enrolled in both Medicare and Medicaid When does the Special Election Period for Dual/LIS Change in Status begin for DSNP members that lose Medicaid eligibility? - Answer- Upon notification or effective date of the loss, whichever is earlier A DSNP might be in the best interest of which of these consumers? - Answer- Joe, whose low income qualifies him for full Medicaid coverage Which statement best describes a care management program that varies depending upon the level of the member's health risk? - Answer- Support provided to CSNP and DSNP members that may have unique health care needs Select the statement that best describes a feature of DSNPs. - Answer- NOT ***********A member can see any participating Medicaid provider 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: - Answer- Selling DSNPs The consumer states they currently pay a percentage of charges when they receive medical care. This means: - Answer- The consumer is not likely to be a Full Dual-Eligible and may be better suited for enrollment in another type of plan. The following is a characteristic of consumers for whom a CSNP may be most appropriate: - Answer- Consumers who have a qualifying chronic condition, are focused on their health issues and may have concerns with having to manage their illness or dealing with multiple providers 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 Chronic Special Needs Plan (CSNP) that covers his chronic condition? - Answer- Yes, he can enroll using his Special Election Period (SEP-Special Need/Chronic) How is a CSNP or DSNP member's care management health risk levels determined initially? - Answer- The member completes a Health Assessment that asks a series of questions about their health status and assistance they may need with activities of daily livi