QQuestionHealthcare
QuestionHealthcare
Select the statement that best describes a feature of D-SNPs.
A. A member can see any participating Medicaid provider.
B. D-SNPs are network-based.
C. D-SNPs do not include prescription drug coverage, so a member may enroll in a stand-alone Prescription Drug Plan in addition to their D-SNP.
D. There is never a cost to the member when receiving care from a provider, even if the provider is out-of-network.
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Answer
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Step 1:: Understand the options given for D-SNPs (Dual Eligible Special Needs Plans).
These are plans that cater to individuals who are eligible for both Medicare and Medicaid.
Step 2:: Analyze the statements based on the features of D-SNPs.
A. A member can see any participating Medicaid provider. This statement is not necessarily true. D-SNPs have a specific network of providers, and while members can see any participating provider, they may not be able to see just any Medicaid provider. B. D-SNPs are network-based. This statement is true. D-SNPs have a specific network of participating providers, which means that enrollees must choose healthcare providers within the plan's network.
Step 3:: Evaluate the remaining options.
C. D-SNPs do not include prescription drug coverage, so a member may enroll in a stand-alone Prescription Drug Plan in addition to their D-SNP. This statement is not true. D-SNPs are required to provide prescription drug coverage, so enrollees do not need a separate stand-alone Prescription Drug Plan. D. There is never a cost to the member when receiving care from a provider, even if the provider is out-of-network. This statement is not true. D-SNPs have cost-sharing requirements, and while many services have no cost-sharing, some services may require copayments or coinsurance, especially if the provider is out-of-network.
Final Answer
Based on the provided information, the best answer is B: D-SNPs are network-based.
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