What is included in all DSNP plans Aetna?
Asked by: Curt Hansen | Last update: August 7, 2025Score: 5/5 (62 votes)
What is the Aetna DSNP plan?
A DSNP is a special type of Aetna® Medicare Advantage Prescription Drug (MAPD) plan. It provides benefits to members who qualify for Medicare and who receive full Medicaid benefits and/or assistance with Medicare premiums or Medicare Parts A & B cost sharing through one of the Medicare Savings Program (MSP) categories.
What is included in all DSNPs plans Aetna Quizlet?
All of our Dual Special Needs Plans (DSNP) includes free monthly fitness club memberships to any facility participating within the SilverSneakers network. Our Aetna Medicare DSNP members currently pay $0 at participating pharmacies.
What are the different types of DSNP plans?
The Centers for Medicare and Medicaid Services (CMS) annually designates D-SNPs as one of three types (Coordination-Only, Highly-Integrated, or Fully-Integrated) to indicate the level of integration between Medicare and Medicaid.
What is the difference between tier 1 and tier 2 Aetna?
Tier 1 – Aetna Premier Care Network Plus Multi-Tier providers. Using a provider from this tier results in maximum savings for Aetna® members. Tier 2 – Aetna Health broad network providers. Using a provider from this tier results in standard savings for Aetna® members.
Medicare Advantage 101: The Promise and Pitfalls of Dual-Eligible Special Needs Plans
What is Tier 2 Blue Cross Blue Shield?
Tier 2 — Other BCBS in-network providers: Through Tier 2 providers, you have access to a nationwide network of healthcare providers and facilities. The deductible, coinsurance, and out-of-pocket maximums are much lower when compared with out-of-network providers.
What best describes a DSNP plan?
D-SNPs are Medicare Advantage (MA) plans that provide specialized care to beneficiaries dually eligible for Medicare and Medi-Cal and offer care coordination and wrap-around services. All D-SNPs in California must have executed contracts with the Department of Health Care Services (DHCS), the state Medicaid agency.
What is a fully integrated DSNP?
Fully Integrated D-SNPs (FIDE SNPs)
FIDE SNPs must cover at least Medicaid primary and acute care services and long-term services and supports (LTSS), including at least 180 days of nursing facility coverage during the plan year.
What do you need to qualify for a DSNP?
In general, you must:
Qualify for original Medicare (Parts A & B) Meet the income and asset requirements for your state's Medicaid program. Live in a service area where D-SNPs are available.
What state did Aetna DSNP expand to in 2024?
It is a type of Medicare plan that provides benefits to individuals who are eligible for both Medicare and Medicaid. DSNP plans are designed to meet the unique needs of individuals who qualify for both programs. In this case, Aetna Medicare DSNP expanded its services into the state of Virginia in 2024.
How do I know which plan I have with Aetna?
If your plan only covers prescriptions, search prescription drug plans (PDP). If you're in an Aetna Medicare Advantage plan (MA or MAPD), your plan name is listed on your Aetna member ID card. If you're in a PDP plan, look at the “S” number on the bottom right of your Aetna member ID card to find your plan.
Do all of our DSNP include free monthly fitness club memberships to any facility?
All of our DSNP include free monthly fitness club memberships to any facility participating within the SilverSneakers network. A member's cost share at a preferred pharmacy will usually be lower than cost share at a standard pharmacy. Aetna medicare DSNP has expanded into this state in 2024.
Do Aetna Medicare DSNP members currently pay $0 at participating pharmacies?
$0 co-pay for Rx drugs
You pay a $0 copay for covered Part D prescription drugs at in-network pharmacies.
Do DSNP members have subsidized premiums?
Yes. Since D-SNP is a Medicare Advantage plan, Medicare covers most of the costs when Medicare members get medical care. The part or share that's left over is the member's responsibility to pay. This may be known as a premium, copay, coinsurance or deductible.
What kind of food can I buy with my Aetna debit card?
Groceries! With your Extra Benefits Card, you can purchase approved healthy foods that help you feel your best. That includes fruits and veggies, meat and seafood, healthy grains like bread and pasta, pantry staples like flour and spices and more.
What are the different types of DSNP?
Fully-Integrated D-SNPs (FIDE-SNPs), currently serving 400,000 people in 13 states and D.C. Highly-Integrated D-SNPs (HIDE-SNPs), currently serving 2.1 million people in 15 states and D.C. Coordination-only D-SNPs (CO DSNPs), currently serving 3.3 million people in 38 states and D.C.
What is the difference between a partially integrated and a fully integrated contract?
Complete integration means that everything is included in the written agreement, while partial integration means that some things are left out and can be clarified with additional evidence.
Which consumer might benefit the most by enrolling in a D-SNP?
A Dual Special Needs plan (D-SNP) is a type of health insurance plan. It's for people who have both Medicare and Medicaid. These plans are designed for people who may need more help because of disabilities, age or health conditions.
What is the model of care for DSNP?
A Dual Special Needs Plan Model of Care (D-SNP MOC) describes how we provide healthcare services to our low-income senior (65+) members and members who have special needs. Our purpose is to provide them with access to care that is reliable, convenient, and accessible.
What are the three types of special needs plans?
- Chronic Condition SNP (C-SNP)
- Dual Eligible SNP (D-SNP)
- Institutional SNP (I-SNP)
Which statement is true about DSNP members?
The true statement about d-snp (Dual Eligible Special Needs Plan) members is that members who are QMB or are full dual-eligible are not required to pay copayments for Medicare-covered services obtained from a d-snp in-network provider.
What does Tier 2 include?
The Tier II form requires specific data for compliance, including the types and quantities of hazardous chemicals stored, their locations, and safety measures. Both programs are pretty straightforward and there are detailed instructions or tutorials on how to use them.