If a DSNP member loses eligibility due to a change in Medicaid status, what costs is the member responsible for during the grace period?

A Dual Eligible Special Needs Plan (DSNP) member is usually covered by both Medicare and Medicaid, which helps to reduce their out-of-pocket costs for healthcare services. However, when a member loses eligibility due to a change in their Medicaid status, the financial responsibility changes.

During the grace period that follows the loss of Medicaid eligibility, the member is responsible for all costs associated with their healthcare plan. This includes premiums, deductibles, co-payments, and coinsurance. As Medicaid often covers a significant portion of these costs for DSNP members, their sudden obligation to pay these expenses can be quite impactful.

Understanding this nuanced aspect is critical, as it emphasizes the member's need to be prepared for potential financial responsibilities during the grace period. The other options do not capture the full scope of the member's financial obligations, which is important to note when considering changes in eligibility status.