When does the Special Election Period for Dual/LIS Change in Status begin for DSNP members losing Medicaid eligibility?

The Special Election Period for Dual/Low Income Subsidy (LIS) Change in Status begins upon the notification or effective date of loss of Medicaid eligibility for Dual-Eligible Special Needs Plan (DSNP) members. This timing is significantly important as it allows eligible beneficiaries to transition smoothly to alternative coverage, ensuring they continue to have access to necessary healthcare services without interruption.

When a DSNP member loses their Medicaid eligibility, timely notification to the individual triggers this Special Election Period. This provision is designed to protect individuals by providing them the opportunity to enroll in a suitable Medicare Advantage plan or a standalone Part D plan that meets their healthcare needs. This proactive approach helps ensure continuity of care for those who may be vulnerable due to the loss of Medicaid benefits.

The other time frames presented, such as the end of a grace period, disenrollment periods, or waiting for notification from the plan, do not align with the immediate nature of the Special Election Period for individuals facing a change in their dual eligibility status. The focus here is on acting promptly once a member is aware of their eligibility changes, thereby facilitating a smoother transition to new coverage options.