Question

Which statement best describes a DSNP?

a) DSNPs are non-network based plans, which enables members to see any Medicare-eligible provider

b) DSNPs do not include prescription drug coverage, so a member may enroll in a stand-alone Prescription Drug Plan in addition to their DSNP

c) The monthly premium is at or below the Low Income Subsidy benchmark to cover drug costs

d) The state government pays half of the plan premium

Answer 1

DSNPs are a type of Medicare Advantage plan with the monthly premium at or below the Low Income Subsidy benchmark, often including prescription drug coverage.

Step-by-step explanation:

The statement that best describes a DSNP (Dual Eligible Special Needs Plan) is that the monthly premium is at or below the Low Income Subsidy benchmark to cover drug costs. DSNPs are a type of Medicare Advantage plan aimed at individuals who are eligible for both Medicare and Medicaid. These plans often include prescription drug coverage, contrary to the claim that DSNPs do not include it. Additionally, while DSNPs are network-based plans, they do provide some flexibility, allowing members to see any Medicare-eligible provider under certain circumstances. It's important to note that the cost of the prescription drug benefit under Medicare was significant, illustrating why such subsidy benchmarks are necessary to make it affordable for low-income individuals.