Dual Special Needs Plan definition

Dual Special Needs Plan and “DSNP” means a specific type of Medicare Advantage Plan for those individuals who have special needs as defined in 42 CFR § 422.2 and meet the eligibility requirements set forth in 42 CFR § 422.52.

Dual Special Needs Plan and “DSN Plan” means a specific type of Medicare Advantage Plan for those individuals who have special needs as defined in 42 CFR § 422.2 and meet the eligibility requirements set forth in 42 CFR § 422.52.

Dual Special Needs Plan means a specialized Medicare Advantage plan for special needs individuals who are entitled to medical assistance under a State plan under title XIX of the Act that coordinates the delivery of Medicare and Medicaid services for individuals who are eligible for such services. Exclusively Aligned Enrollment means State policy limits a D-SNP’s membership to individuals whose Medicaid benefits are covered under a Medicaid managed care organization contract under section 1903(m) of the Act between the applicable State and: the dual eligible special needs plan's (D-SNP's) MA organization, the D-SNP's parent organization, or another entity that is owned and controlled by the D-SNP's parent organization. Family Care Partnership Program is a capitated integrated Medicaid managed care program that provides both managed Medicaid long-term care and health care benefits. Members enrolled in Partnership must have a Wisconsin Medicaid nursing home-certifiable level of care. MA Plan means health benefits coverage offered under a policy or contract by an MA organization that includes a specific set of health benefits offered at a uniform premium and uniform level of cost-sharing to all Medicare beneficiaries residing in the service area of the MA plan.

Examples of Dual Special Needs Plan in a sentence

• Finally, the MA Health Plan shall identify for the Department on Appendix A, which categories of Dual Eligible individuals are eligible to enroll in the Dual Special Needs Plan.

• Dual Special Needs Plan Contractors in Coordinated Care Initiative counties (Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Mateo, and Santa Xxxxx counties) must have a Dual Special Needs Plan (D-SNP) available to dual eligible Members for contract year 2024 and must provide documentation of the Centers for Medicare & Medicaid approval of the D-SNP by December 2, 2023.

• MA Health Plan holds an agreement with CMS to provide a Dual Special Needs Plan covered under this SMAC (or another organization under same parent company) and receives direct capitation from HCA to provide coverage of the Medicaid benefits described in the Integrated Managed Care (IMC) Contract including BH Services listed in Exhibit 5.

• MA Health Plan holds an agreement with CMS to provide a Dual Special Needs Plan covered under this SMAC (or another organization under the same parent company) and receives direct capitation from HCA to provide coverage of the Medicaid benefits described in the Integrated Managed Care (IMC) Contract including BH Services listed in Exhibit 5.