Question

Meredith, a Dsnp member, loses medicaid eligibility. What impact does this has on her dsnp enrollment?

Answer 1

If a member loses their Medicaid eligibility, they move into a “deemed” eligibility status for DSNP for six months. During this grace period, the member is responsible for the Medicare cost-sharing portion, which includes copayments, coinsurance, deductibles and premiums.

Answer 2

She will not lose her DSNP application right away because the DSNP will give her a period of time to regain eligibility for Medicaid.

If that period of time passes without her eligibility being regained, she will lose her DSNP membership.

It is important to emphasize that the DSNP is a health plan aimed at obtaining prescription drugs. This plan is aimed at Medicaid customers who have contracts with Parts A and B.

• Loss of eligibility, in this case, occurs when a client loses Medicaid coverage and this can happen in the following ways:
• Lack of proper documentation.
• Delivery of incorrect documents.
• Failure to present civil status or change of civil status.
• Very high family income.

In this case, a customer who loses Medicaid coverage will lose DSNP eligibility, but the DSNP system will allow 30 to 180 days for the customer to regain eligibility, otherwise the application will be cancelled.

You can get more information about Medicaid at the link below:

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