PHARMACY TECHNICIAN FINAL PAPER
FULL QUESTIONS AND CORRECT ANSWERS
REVIEW MATERIAL
●● Medicare
Answer: Provides service for the elderly and disabled individuals (must
meet a certain criteria)
●● Medicaid
Answer: Provides service for lower income individuals. Federally and
state funded
●● Tricare
Answer: AKA military insurance; provides service to veterans and
soldiers
●● NIH
Answer: National Institute of Health
●● Employer Insurance
Answer: Most employers provide health insurance to full time
employees
,●● Private Insurance
Answer: Individuals can apply and pay for health insurance. Smaller
businesses offer group rates to their employees.
●● Copay
Answer: The remaining amount an individual must pay for their
medication after insurance. This form of payment is collected at the
point of sale (ie the pharmacy)
●● Medicare A
Answer: Covers inpatient hospital stays
●● Medicare B
Answer: Covers outpatient hospital stays and diabetic supplies, DME
(durable medical equipment), patients on long term disabilities, X-rays,
dialysis, vaccines, and respiratory nebulizers
●● Medicare C
Answer: Additional coverage not covered under A or B. Often called the
advantage plan or choice plan.
●● Medicare Part D
Answer: Covers prescription medications; usually processed by private
insurance but funding is provided by CMS (government)
,●● Medicare Part E
Answer: Supplemental coverage; covers A, B, and D (Different than just
Medicare C)
Medicare C only covers A and B
●● HMO
Answer: Health Maintenance organization
●● Health Maintenance Organization (HMO)
Answer: With an HMO plan, you must select a primary care physician
(PCP) from .a network of local healthcare providers who will refer you
to in-network specialists or hospitals when necessary.
All of your care is coordinated through your PCP
Lost cost to the insurance and the patient
●● PPO
Answer: preferred provider organization
●● Perferred Provider Organization (PPO)
Answer: Recommended list of in-network providers and hospitals
, -If you choose a provider outside of your network, your copay may be
higher
-More flexibility= pay more money per month
●● EPO
Answer: Exclusive Provider Organization
●● Exclusive Provider Organization (EPO)
Answer: Sort of like a combination between HMO's and PPO's
-There is a recommended list of providers and specialists but cannot pick
a provider outside of network
-You can pick any primary care physician but they must be in-network
●● Workers Compensation
Answer: When a patient has been hurt at work and his/her company has
agreed to pay for the cost of his/her medication
●● out of pocket
Answer: Individuals without health care coverage and have to pay out of
pocket expenses
●● Pharmacy Benefit Managers
Answer: PBM
FULL QUESTIONS AND CORRECT ANSWERS
REVIEW MATERIAL
●● Medicare
Answer: Provides service for the elderly and disabled individuals (must
meet a certain criteria)
●● Medicaid
Answer: Provides service for lower income individuals. Federally and
state funded
●● Tricare
Answer: AKA military insurance; provides service to veterans and
soldiers
●● NIH
Answer: National Institute of Health
●● Employer Insurance
Answer: Most employers provide health insurance to full time
employees
,●● Private Insurance
Answer: Individuals can apply and pay for health insurance. Smaller
businesses offer group rates to their employees.
●● Copay
Answer: The remaining amount an individual must pay for their
medication after insurance. This form of payment is collected at the
point of sale (ie the pharmacy)
●● Medicare A
Answer: Covers inpatient hospital stays
●● Medicare B
Answer: Covers outpatient hospital stays and diabetic supplies, DME
(durable medical equipment), patients on long term disabilities, X-rays,
dialysis, vaccines, and respiratory nebulizers
●● Medicare C
Answer: Additional coverage not covered under A or B. Often called the
advantage plan or choice plan.
●● Medicare Part D
Answer: Covers prescription medications; usually processed by private
insurance but funding is provided by CMS (government)
,●● Medicare Part E
Answer: Supplemental coverage; covers A, B, and D (Different than just
Medicare C)
Medicare C only covers A and B
●● HMO
Answer: Health Maintenance organization
●● Health Maintenance Organization (HMO)
Answer: With an HMO plan, you must select a primary care physician
(PCP) from .a network of local healthcare providers who will refer you
to in-network specialists or hospitals when necessary.
All of your care is coordinated through your PCP
Lost cost to the insurance and the patient
●● PPO
Answer: preferred provider organization
●● Perferred Provider Organization (PPO)
Answer: Recommended list of in-network providers and hospitals
, -If you choose a provider outside of your network, your copay may be
higher
-More flexibility= pay more money per month
●● EPO
Answer: Exclusive Provider Organization
●● Exclusive Provider Organization (EPO)
Answer: Sort of like a combination between HMO's and PPO's
-There is a recommended list of providers and specialists but cannot pick
a provider outside of network
-You can pick any primary care physician but they must be in-network
●● Workers Compensation
Answer: When a patient has been hurt at work and his/her company has
agreed to pay for the cost of his/her medication
●● out of pocket
Answer: Individuals without health care coverage and have to pay out of
pocket expenses
●● Pharmacy Benefit Managers
Answer: PBM
