Which consumer is least likely to qualify for a DSNP?

The least likely consumer to qualify for a Dual Eligible Special Needs Plan (DSNP) is someone who pays a percentage of charges for medical care. DSNPs are specifically designed for individuals who are dually eligible for both Medicare and Medicaid, which typically means they are low-income individuals with varying financial situations.

Those who pay a percentage of charges for medical care often have some level of income or assets that disqualify them from Medicaid eligibility, as Medicaid is aimed at supporting low-income individuals. This scenario indicates a capacity to afford some medical care costs, suggesting that the individual may not fit the income criteria necessary for Medicaid.

In contrast, individuals like Joe, who has a fixed income, or those qualifying for Medicaid with no income, may meet the eligibility requirements for a DSNP due to their financial status. Someone already enrolled in a DSNP also clearly qualifies, as they are the very individuals these plans are designed to accommodate. Thus, the scenario in which the individual is paying a percentage of charges highlights a financial situation that is less aligned with the DSNP enrollment criteria.