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WTI Insurance Ch. 3

Medical Insurance for Pharmacy Techs

QuestionAnswer
True or False: People who are not covered by entitlement programs such as government-sponsored health insurance cannot get insurance. False
True or False: Many employees have medical insurance coverage under group health plans that their employers buy from insurance companies. True
True or False: Pharmacy benefit managers are hired by employers to operate their prescription drug benefit more inexpensively. True
True or False: The largest employer-sponsored health program in the United States is the Federal Employees Health Benefits program. True
True or False: Self-funded health plans are regulated by state laws. False
True or False: Almost 40 percent of people with private health insurance have individual plans. False
True or False: Preferred provider organizations have the largest membership. True
True or False: Patients who belong to a preferred provider organization are required to see providers within the network. False
True or False: In health maintenance organizations patients must use the plan’s network of health care providers in order to have medical services covered under the plan’s terms. True
True or False: In some health maintenance organization plans a primary care physician, also known as a gatekeeper, is assigned to each patient. True
Many employees have medical insurance coverage under group health plans (GHP) that their employers buy from: Insurance companies
What can employees purchase to add coverage such as vision and dental services? Riders and Options
A third-party administrator of prescription drug programs that processes and pays prescription drug claims is called a(n): Pharmacy benefit manager
The amount of time that must pass before a newly hired employee or a dependent is eligible to enroll in a health plan is the: Waiting period
Open enrollment periods are usually offered: Once per year
Employees can customize their policies by choosing to accept various levels of: Deductibles, Other costs, and Premiums
An individual who enrolls in a plan at a time other than the earliest possible enrollment date or a special enrollment date is called a: Late enrollee
The Federal Employees Health Benefits program covers approximately how many people among federal employees, retirees, and their families? 8 million
Approximately what percent of people with private health insurance have individual plans? 10%
Purchasers of private insurance are likely to include all of the following: Students, Recent college graduates, Early retirees
Created by: lrhamyWTI