If Medicaid eligibility is not reestablished after the grace period ends, what happens to the D-SNP enrollment?

• A. They stay enrolled with no changes
• B. They automatically enroll in a stand-alone PDP
• C. They receive full Medicaid outside the plan
• D. They are disenrolled from the D-SNP

Answer: (D)

D-SNPs are designed for people who have both Medicare and Medicaid and rely on Medicaid eligibility to coordinate benefits. When Medicaid eligibility isn’t reestablished after the grace period, the member no longer meets dual-eligibility requirements, so the plan can’t continue to enroll them as a D-SNP. The enrollment is thus terminated from the D-SNP. If they still need coverage, they would transition to another Medicare option that doesn’t coordinate with Medicaid, such as a standard Medicare Advantage plan or a standalone Part D plan, depending on their new eligibility.