Which of the following correctly distinguishes a D-SNP from the other two major types of Medicare Special Needs Plans?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Medicare Advantage Special Needs Plans restrict enrollment to special-needs beneficiaries in three categories: D-SNPs for dual-eligible individuals entitled to both Medicare and Medicaid, whose benefits are coordinated across the two programs, with the state Medicaid program sometimes paying Medicare cost-sharing; C-SNPs for beneficiaries with severe or disabling chronic conditions; and I-SNPs for beneficiaries who live in institutions or require institutional-level care. Knowing which population each SNP type serves is the key to distinguishing them.
Why the other options are wrong
- B) End-stage renal disease is not the D-SNP criterion; D-SNPs are defined by dual Medicare-Medicaid eligibility, and age alone does not enroll anyone in any SNP.
- C) All SNPs are Medicare Advantage (Part C) plans that provide Medicare coverage in place of Original Medicare; none of them merely supplements Original Medicare the way Medigap does.
- D) Every SNP type restricts enrollment to its qualifying special-needs population; none is open to all Medicare beneficiaries, and individual evidence of insurability is not the enrollment criterion.
Memory hook
D-SNP = duals only: Medicare + Medicaid under one coordinated plan, with the state chipping in on cost-sharing.