Theoric Medicare Rx Assessment

If I get a PDP call, I should handle it as any other pharmacy call

• True

• False

If I get a MAPD call, I should handle it as normal.

• True

• False

The deductible commonly applies for the following drug tiers (Select all that apply):

• Tier 2

• Tier 4

• Tier 5

• Tier 3

The amount a member must pay for drugs before their insurance begins to pay its share.

• Co-payment

• Troop

• Deductible

• Co-Insurance

What is the initial coverage limit?

• $4,130

• $4,660

• $4,430

• $7,400

What is the Troop for 2023:

• $4,430

• $6,550

• $7,050

• $7,400

If a member wants to report a COB is terminated what is the right process?

• Collect the previous insurance info including the termination date and send tracker to GOV-COBMSP

• Do a conference call with the coordination of benefits contractor at 855-798-2627

• Member must call the other insurance to cancel that.

How much a member must pay for drugs during initial coverage if they have LIS C

• Generics $0.00

  Brands $0.00

• Generics: 15%

  Brands: 15%

• Generics $4.15

  Brands $10.35

• Generics $1.45

  Brands $4.30

Check on the formulary if the following medication Oxandrolone tab 2.5mg, has any limitation and what is the tier. (such as QL, PA or ST)

• Tier 3

  and needs PA

• Tier 3

  and has QL

• Tier 2

  and needs PA

• Tier 2

  and has ST

What are the step 1 medications for Febuxostat 80 mg table?(select all that apply)

• Probenecid tab 500 mg

• Alendronate tab 70 mg

• Allopurinol 100mg tablet

• Allopurinol 300mg tablet