Under D-SNPs, when Medicaid is lost, which statement about cost-sharing applies?

• A. They pay no cost-sharing.
• B. They will be responsible for all cost-sharing.
• C. They switch to Medicaid-only coverage.
• D. They gain full benefits automatically.

Answer: (B)

When a plan is a D-SNP, Medicaid coverage often reduces or waives certain cost-sharing for services, using the coordination between Medicare, the plan, and Medicaid to lower the beneficiary’s out-of-pocket costs. If Medicaid eligibility is lost, that shared responsibility disappears, and the member must rely on the standard cost-sharing rules of the Medicare Advantage plan. In practical terms, the individual would be responsible for the full cost-sharing amounts that apply to Medicare-covered services under the plan, since Medicaid is no longer paying or waiving those costs.

So the best answer reflects that shift: they become responsible for all cost-sharing. The other options imply protections or changes that don’t occur simply because Medicaid is lost (no cost-sharing protection, automatic switch to Medicaid-only, or automatic gain of full benefits), which isn’t how cost-sharing coordination works in this scenario.