2021/2022 United HealthCare 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 Which statement is true about how loss of Medicaid affects a member's enrollment in a DSNP? - 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? - 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? - 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: - 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. Which of the following consumer characteristics demonstrates a good fit for a CSNP? - 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? - 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? - 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: - 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.