When enrolling a Dual Eligible Special Needs Plan (D-SNP) beneficiary, what must be verified?

When enrolling a Dual Eligible Special Needs Plan (D-SNP) beneficiary, it is essential to verify the beneficiary's plan enrollment eligibility. D-SNPs are specifically designed for individuals who qualify for both Medicare and Medicaid. This means that confirming a beneficiary's dual eligibility is critical to ensure that they meet the specific criteria required for enrollment in such plans.

Verifying plan enrollment eligibility involves checking whether the individual is currently enrolled in both Medicare (Parts A and B) and Medicaid, as this dual eligibility defines their eligibility for D-SNPs. This step is crucial to ensure compliance with regulations and to guarantee that the beneficiary can access the benefits tailored for dual-eligible individuals. Enrolling an individual who does not meet these criteria could result in complications regarding their coverage and access to care.

The other options, while they may seem relevant, do not directly pertain to the eligibility required for enrollment in a D-SNP. Current health conditions and family income levels might be important for assessing specific needs or determining appropriate plans, but they are not prerequisites for enrollment. Similarly, previous enrollment history may provide context but does not determine eligibility for D-SNP enrollment. Therefore, the verification of plan enrollment eligibility is the key and necessary step in this process.