A Medicare Special Needs Plan (SNP) for dual-eligible beneficiaries (D-SNP) is designed for people who...
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
A Special Needs Plan is a type of Medicare Advantage plan that targets a specific population, and the dual-eligible SNP (D-SNP) serves beneficiaries who qualify for both Medicare and Medicaid (Medi-Cal in California). Because these beneficiaries receive state assistance, the D-SNP coordinates the two programs, and for those not eligible for full Medi-Cal benefits, coverage can include a Medi-Cal share-of-cost feature. D-SNPs generally provide the prescription drug benefit (MAPD) and are designed around the care needs of low-income, medically complex members. This dual-eligibility design is a specific Medicare Advantage product point in the senior health products outline.
Why the other options are wrong
- B) A D-SNP requires Medicare entitlement; employer coverage alone does not qualify anyone for the plan.
- C) SNP eligibility turns on dual eligibility, not on being under 50.
- D) The beneficiary must be enrolled in Medicare; the plan cannot serve those never enrolled.
Memory hook
D-SNP bridges the dual-eligible who holds both Medicare and Medi-Cal cards.