When enrolling a D-SNP beneficiary, what should be verified?

Verifying the plan enrollment eligibility and MSP (Medicare Savings Program) program level is crucial when enrolling a D-SNP (Dual Special Needs Plan) beneficiary. This ensures that the beneficiary meets the specific criteria required for enrollment in the D-SNP. D-SNPs are designed for individuals who are eligible for both Medicare and Medicaid, and they have specific guidelines related to eligibility that must be adhered to.

Understanding and confirming the beneficiary’s eligibility for the plan ensures that they will receive the correct benefits and access to services that cater to their dual eligibility status. The MSP program level is also important because it may affect the financial aspects of healthcare coverage, such as premiums and cost-sharing, which can be significant for beneficiaries. Thus, ensuring that the beneficiary qualifies for both the D-SNP and any applicable MSP is essential for providing them with the appropriate care and support.

Other aspects, such as understanding beneficiaries' previous healthcare providers, their language proficiency, or the cost of coverage options, while important in other contexts, do not have the same immediate relevance to the eligibility determination process for D-SNP enrollment. These factors may assist in the overall care and accessibility for the beneficiary but do not directly impact their eligibility status.