Knowledge Check

Front

If a member will insist to have an OON provider as their PCP, what jobaid should we check to get the Primary Care Physician Numbers?

Back

Generic PCP Numbers

Front

It is a type of health care plan under which the covered individual can choose the health care provider they want.

Back

PPO

Front

FULFILLMENT: A list that you get after you've received a medical service, drug or item. This list tells you the full price of the service, drug or item that you received. It also tells you how much you may need to pay for it.

Back

Explanation of Benefits

Front

HIPAA: Health Insurance Portability and Accountability Act was created in what year?

Back

1996

Front

The amount the member, the plan, and others on the member's behalf pay for prescription drugs starting at the beginning of each new plan year (e.g., January 1). This does not include premiums. What is this called?

Back

TOTAL DRUG COSTS

Front

TRUE OR FALSE:

Premiums do not count toward moving a member into or out of any of these stages. The premium is just the cost of having the plan.

Back

TRUE

Front

What type of deductible does the member have if their deductible charges starts from Tier 3 medication?

Back

Split-Tier Deductible

Front

What is the 2nd P in MPPP?

Back

Payment

Front

LOW INCOME _______? Medicare beneficiaries with limited income and resources may qualify for extra help paying for Medicare Part D affiliated costs through this program.

Back

Subsidy

Front

This Coverage information is provided to assist with queries regarding the SPAP's secondary coordination of benefits to PDP and MAPD plans.

Back

State Pharmaceutical Assistance Program