Final answer:
Members who lose their DSNP eligibility due to Medicaid status changes are responsible for all forms of cost sharing, such as premiums, deductibles, copayments, and coinsurance. Cost-sharing measures discourage moral hazard by making individuals pay a portion of their healthcare costs, affecting consumption and overall costs.
Step-by-step explanation:
When members lose their eligibility for the Dual Eligible Special Needs Plan (DSNP) due to a change or loss of Medicaid status, they are generally responsible for all forms of cost sharing such as premiums, deductibles, copayments, and coinsurance. Medicare Part A and Part B consist of various forms of cost sharing, including deductibles and copayments. These cost-sharing measures are known to discourage moral hazard, as they require individuals to pay a portion of their healthcare costs, thereby reducing the consumption of medical care among those with moderate deductibles and copayments compared to those with more comprehensive coverage.
DSNP and Cost Sharing
For DSNP members, this means after losing Medicaid eligibility, they would be liable for costs that may have been previously covered by Medicaid, including the Part D and Part A premiums, usually covered by Medicaid for DSNP enrollees. It is essential for individuals to be aware of these potential costs and how the loss of Medicaid affects their Medicare coverage.