How do DSNPs differ from standard MA plans?

• A. They are identical to standard MA plans.
• B. They are only for people under 65.
• C. They are tailored for dual eligibles with integrated benefits and must coordinate with Medicaid.
• D. They do not coordinate with Medicaid.

Answer: (C)

Dual Eligible Special Needs Plans are Medicare Advantage plans designed for people who qualify for both Medicare and Medicaid. They integrate benefits across the two programs and require coordination with Medicaid to cover Medicaid-held services and supports, such as long-term care and additional help with care management. This Medicaid coordination and integrated benefit structure is what distinguishes DSNPs from standard MA plans, which operate only within Medicare and don’t coordinate with Medicaid. So, these plans are specifically tailored for dual eligibles with benefits that align Medicare and Medicaid coverage. The other options don’t fit because standard MA plans don’t coordinate with Medicaid, DSNPs aren’t limited to under-65 individuals, and DSNPs do coordinate with Medicaid.