What is Lucille's responsibility for cost sharing after losing eligibility for her D-SNP?

The correct understanding centers on the implications of losing eligibility for a Dual Eligible Special Needs Plan (D-SNP). When an individual like Lucille loses her eligibility for a D-SNP, she transitions out of the comprehensive benefits model provided by the plan tailored to those with dual eligibility (Medicare and Medicaid).

In this situation, the individual is generally held accountable for all associated costs under a standard plan, which includes not just premiums but also deductibles, copayments, and coinsurance. This full range of cost-sharing responsibilities arises because, without the specific protections and coverage afforded by a D-SNP, Lucille would need to navigate standard Medicare coverage without the additional assistance that Medicaid provides.

Understanding this framework helps clarify the financial obligations that accompany a shift from D-SNP to a traditional plan, emphasizing the importance of being prepared for all potential costs involved.