Summary of Benefits and Coverage (Level 2—Understanding)
Use figure 2.1 from the textbook to identify the cost-sharing components. Complete the following questions. Each item is worth 8 points.
Question
1 – What is the cost-sharing for a generic drug, network provider?
2 – What is the cost-sharing for a tier 2 drug purchased at an out-of- network pharmacy?
3 – What is the cost-sharing for a specialty drug, network provider?
4 – What is the cost-sharing for a network immunization visit?
5 – What is the cost-sharing for a network primary care visit
6 – What is the cost-sharing for a network specialist visit?
7 – What is the cost-sharing for an out-of-network primary care visit?
8 – What is the cost-sharing for x-rays provided by a network provider?
9 – What is the cost-sharing for outpatient surgery provided at a network facility?
10 – What is the cost-sharing amount for the surgeon fees for outpatient surgery provided at an out-of-network facility?