For a D-SNP member who loses Medicaid eligibility, when does the Special Election Period begin?

• A. Upon notification of the loss
• B. On the date the loss occurs
• C. Upon notification or effective date of the loss, whichever is earlier
• D. The first day of the following month

Answer: (C)

When a D-SNP member loses Medicaid eligibility, the Special Election Period is triggered by an event that marks the change in eligibility, and it starts at the earliest of two dates: the date the loss actually occurs, or the date the member is notified of that loss. This ensures the member can enroll in or switch plans as soon as the change is known, avoiding gaps in coverage.

If it were only the notification date, some members might experience a delay if the loss date happened earlier than the notice. If it were only the loss date, notification timing could still cause delays in starting the SEP. The rule to begin at the earlier of the two dates covers all scenarios. The first day of the following month doesn’t align with event-based triggers and isn’t used here.