Why You Need a Disclaimer When Marketing Dual Special Needs Plans


Medicare Dual Eligible Special Needs Plan (D-SNP) enrollees are eligible for the combined benefits of Medicare and Medicaid services. Brokers can reach out to prospects or clients who qualify for a D-SNP, but the marketing material must include a specific disclaimer.

What Is the D-SNP Disclaimer?

According to CMS rules (MMG Appendix 2), the following disclaimer must be used on all D-SNP marketing materials that mention cost-sharing information to residents in the United States: Premium, copays, coinsurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.

This disclaimer is not required on material for beneficiaries who live in the territories.

When Is the D-SNP Enrollment Period?

D-SNP beneficiaries qualify for SEP. They can enroll and/or switch plans at the start of every month and during AEP.

D-SNP Categories

D-SNP Medicaid assistance can range from full service to only help with Medicare premiums or cost sharing. There are five categories of D-SNPs.

  1. All-Duel D-SNPs
  2. Full-Benefit D-SNPs
  3. Medicare Zero Cost Sharing D-SNPs
  4. Dual Eligible Subset D-SNPs (with cost sharing)
  5. Dual Eligible Subset D-SNPs (without cost sharing)

Dual eligible coverage is dependent on income and asset thresholds.

Where Can I Get More Medicare Marketing Guidance?

Our resource center is available 24/7 to give you the help you need with Medicare guidelines, sales advice, and more to keep your business on track. To learn more about the Excelsior team and how we can help you, contact us.

 

https://www.cms.gov/Medicare/Health-Plans/SpecialNeedsPlans/DualEligibleSNP.html | https://www.cms.gov/Medicare/Health-Plans/SpecialNeedsPlans/Downloads/Special-Need-Plans-SNP-Frequently-Asked-Questions-FAQ.pdf

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References
https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/CY2019_Medicare_Communications_and_Marketing_Guidelines.pdf

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