SNBC Guide

Overview

• Q: What is Special Needs Basic Care (SNBC)? A: SNBC is a voluntary managed care program for people with disabilities ages 18–64 who have Medical Assistance (MA), with or without Medicare; it provides managed care plan options instead of Fee‑for‑Service (FFS).
• Q: What’s the difference between SNBC integrated and non‑integrated plans? A: Integrated plans (I‑SNBC) combine MA and Medicare services (including Part D); non‑integrated plans (SNBC‑NI) cover MA services only.

Roles and referrals

• Q: What is the Disability Hub OC role for SNBC? A: Options Counselors (OCs) review current benefits, provide options counseling, explain how to enroll/opt‑out, and guide next steps (including warm transfers when needed).
• Q: Who verifies system exclusions and benefit status? A: The DSD team verifies current benefits and informs the Hub of any exclusion codes in state systems.
• Q: Who processes SNBC Choice forms and handles enrollment decisions? A: DHS Managed Care processes SNBC Choice forms and approves or denies enrollments.
• Q: When should I refer to the Managed Care Ombudsman? A: Refer when someone needs help accessing healthcare services, addressing billing concerns, or when plan support is not resolving care issues.

Eligibility

• Q: Who is eligible for SNBC? A: People ages 18–64 who are certified blind or disabled by SSA or SMRT and who have MA; Medicare enrollees with Parts A and B may choose integrated options.
• Q: Are people with a spenddown eligible for SNBC? A: People with a spenddown are not eligible to newly enroll in SNBC. If already enrolled and they incur a spenddown, they may remain enrolled if the spenddown is met each month and paid to DHS in full (or paid to a designated provider when receiving PCA/waiver services).
• Q: Can someone enrolled in cost‑effective employer insurance or another HMO join SNBC? A: No — enrollment is restricted if the person has cost‑effective third‑party insurance or other HMO coverage, as determined by the financial worker.

Timing and plan changes

• Q: What is the capitation (cutoff) date for managed care changes? A: The capitation date is six working days from the last working day of the month; changes must be made by that date to take effect the following month.
• Q: How often can SNBC plan changes be made? A: SNBC‑NI plan changes can be made monthly via the SNBC Choice Form; I‑SNBC plan changes (enroll/disenroll) are handled directly with the health plan and can be done monthly through the plan.
• Q: What if an SNBC Choice Form is submitted on capitation day? A: Forms submitted on capitation day may not be processed in time for the next month’s effective date.

Options counseling — how to help

• Q: What steps should OCs follow for SNBC options counseling? A: 1) Review current benefits using MNITS Look Up and BLU to confirm eligibility criteria; 2) Explain SNBC vs FFS and I‑SNBC vs SNBC‑NI if Medicare applies; 3) Review local plan options (map/directory), provider networks and formularies; 4) Support the person’s decision and next steps (form submission or warm transfer).
• Q: What should I check in MNITS/BLU during Step One? A: MA type, spenddown type, whether MA is ending, exclusion codes, current SNBC enrollment (MA‑37/MA‑17), current/future integrated plan enrollment, and third‑party cost‑effective insurance.
• Q: What plan details should I verify when reviewing options? A: Provider network coverage for necessary providers and whether prescriptions are covered (check formularies and Part D interactions for Medicare enrollees).

Enrollment, disenrollment, and transfers

• Q: How does someone enroll in or change non‑integrated SNBC plans? A: Use the SNBC Choice Form (online, mail, or fax) to enroll, disenroll, or opt out of SNBC‑NI.
• Q: How does someone enroll in an integrated SNBC plan? A: Warm transfer the person to their chosen I‑SNBC health plan to complete enrollment, or instruct them to call the plan directly.
• Q: How should we handle disenrollment from an integrated plan? A: Warm transfer the person to their I‑SNBC plan for disenrollment, or transfer to MAP to enroll in a Part D plan (which will disenroll them from SNBC and return them to FFS).
• Q: What signature or confirmation is required for the SNBC Choice Form? A: The person or their Authorized Representative must sign; a submission confirmation appears after online submission.
• Q: Where do people mail or fax the SNBC Choice Form? A: Mail to MN Dept of Human Services, Managed Care Enrollment, PO Box 64838, St. Paul, MN 55164‑0838; fax to 651‑431‑7464.

Spenddowns and past‑due amounts

• Q: What are the payment options for people with SNBC and a spenddown? A: Option 1 — pay the spenddown directly to DHS (DHS invoices monthly); Option 2 — if receiving PCA/CFSS or HCBS waiver services, pay a designated provider who bills monthly.
• Q: What happens if spenddowns go unpaid for 3 months? A: DHS will automatically disenroll the person from their SNBC plan and mail a notice that coverage is ending.
• Q: How can someone re‑enroll after being disenrolled for past‑due spenddowns? A: Pay past‑due spenddowns in full within 90 days, contact DHS Billing to confirm payment, and request DHS Billing notify Managed Care Enrollment to remove the unpaid spenddown exclusion code; DHS Managed Care then allows re‑enrollment.
• Q: Who can a person contact for account summaries about spenddowns? A: DHS Billing can provide an account summary to show what is owed and what has been paid.

Coverage continuity and network issues

• Q: What are transition services if a provider is out of network after a plan change? A: All plans provide transition services to maintain continuity of care; help the person contact their SNBC plan to request transition services.
• I-SNBC 90 grace period
• Q: What should I do if the plan cannot resolve transition needs? A: Contact the Managed Care Ombudsman’s office for assistance.

Care coordination

• Q: How do I find out how care coordinators are assigned or what they do? A: Contact the specific SNBC plan to learn about that plan’s care coordination model and the role of care coordinators.

Common quick replies for Genesys

• Q: “How do I change my SNBC plan?” A: “If you want to change a non‑integrated plan, submit the SNBC Choice Form online, by mail, or by fax; for integrated plans, call or let me warm transfer you to the health plan to complete enrollment.”
• Q: “I missed payments and my SNBC ended — how do I get back in?” A: “You’ll need to pay past due spenddowns in full within 90 days, confirm payment with DHS Billing, and ask DHS Billing to notify Managed Care Enrollment so the unpaid spenddown exclusion can be removed.”
• Q: “What if my needed doctor isn’t in the new plan?” A: “Ask the plan for transition services to continue care while they help you find an in‑network provider; if the plan can’t help, we can refer you to the Managed Care Ombudsman.”

Resources and references

• Q: What resources should I use during SNBC counseling? A: Guide to SNBC Enrollment; SNBC Health Plan Choices by County map; SNBC Plan Directory (DHS); Managed Care Summary of Coverage; Rights and Responsibilities for SNBC; SNBC Choice Form; SNBC 6451 eDoc.