If a Dual Eligible Special Needs Plan member loses Medicaid eligibility, what happens to their D-SNP enrollment?

• A. She continues in the D-SNP with no changes
• B. She will enter a grace period and may be disenrolled if Medicaid is not reestablished
• C. She is immediately disenrolled
• D. She must switch to a standalone PDP

Answer: (B)

D-SNPs are specifically for people who have both Medicare and Medicaid, so ongoing Medicaid eligibility is essential to stay enrolled in the D-SNP. If a member loses Medicaid, there is a grace period during which Medicaid can be reestablished. If Medicaid is not reestablished within that window, the member may be disenrolled from the D-SNP. This setup protects the alignment of benefits and funding for dual-eligible individuals.