MCQ Quiz: Introduction to Prescription Insurance

Understanding prescription insurance is essential for pharmacists to assist patients in accessing medications affordably. This topic encompasses types of insurance, formularies, co-pays, prior authorizations, and claim adjudication. This quiz aligns with Pharm.D. courses like CIPPE and PHA5561 to help students grasp the practical and administrative aspects of pharmacy benefit management.

1. Prescription insurance primarily helps to:

  • A. Increase drug prices
  • B. Reduce patient out-of-pocket costs
  • C. Eliminate doctor visits
  • D. Delay medication access
    Correct answer: B. Reduce patient out-of-pocket costs

2. A formulary is:

  • A. A drug manufacturing guide
  • B. A list of approved medications covered by an insurance plan
  • C. A pharmacist’s reference book
  • D. A legal document
    Correct answer: B. A list of approved medications covered by an insurance plan

3. Co-pay refers to:

  • A. A refund for unused medication
  • B. The fixed amount a patient pays for a prescription
  • C. The total drug cost
  • D. Pharmacist wages
    Correct answer: B. The fixed amount a patient pays for a prescription

4. Prior authorization is required when:

  • A. A drug is over-the-counter
  • B. A high-cost or non-formulary drug is prescribed
  • C. A patient requests it
  • D. Any prescription is filled
    Correct answer: B. A high-cost or non-formulary drug is prescribed

5. Which of the following best describes claim adjudication?

  • A. Filing a lawsuit
  • B. Processing a prescription claim electronically with an insurer
  • C. Making a cash transaction
  • D. Reviewing a drug label
    Correct answer: B. Processing a prescription claim electronically with an insurer

6. What does “Tier 1” in a formulary usually indicate?

  • A. Brand-name drugs
  • B. Non-covered drugs
  • C. Preferred generic medications with lowest co-pay
  • D. High-risk medications
    Correct answer: C. Preferred generic medications with lowest co-pay

7. A deductible in insurance is:

  • A. The amount the insurance pays for each prescription
  • B. The total cost of insurance
  • C. The amount a patient must pay before insurance starts covering costs
  • D. A fine for non-compliance
    Correct answer: C. The amount a patient must pay before insurance starts covering costs

8. A pharmacy benefit manager (PBM):

  • A. Manages the physical layout of the pharmacy
  • B. Controls prescription benefits on behalf of insurers
  • C. Manufactures drugs
  • D. Approves new drugs for the market
    Correct answer: B. Controls prescription benefits on behalf of insurers

9. Which of these plans is a government-funded prescription program?

  • A. PPO
  • B. Medicare Part D
  • C. HMO
  • D. Bronze Plan
    Correct answer: B. Medicare Part D

10. If a drug is “not covered,” a pharmacist may:

  • A. Dispense it anyway
  • B. File a prior authorization request or recommend an alternative
  • C. Discard the prescription
  • D. Bill the prescriber
    Correct answer: B. File a prior authorization request or recommend an alternative

11. Dual eligibility in insurance means:

  • A. Patient has no insurance
  • B. Patient qualifies for both Medicare and Medicaid
  • C. Two prescriptions per visit
  • D. Two insurance companies always pay full price
    Correct answer: B. Patient qualifies for both Medicare and Medicaid

12. Coordination of benefits refers to:

  • A. Communication between doctor and pharmacist
  • B. Process to determine which insurance pays first
  • C. Distribution of drugs from manufacturer
  • D. Timing medication intake
    Correct answer: B. Process to determine which insurance pays first

13. An Explanation of Benefits (EOB) is:

  • A. A detailed receipt from the pharmacy
  • B. A document outlining insurance claim outcomes
  • C. A physician referral
  • D. A lab test report
    Correct answer: B. A document outlining insurance claim outcomes

14. Which plan type generally allows patients to choose any provider but at a higher cost?

  • A. HMO
  • B. PPO
  • C. Medicaid
  • D. Medicare Part A
    Correct answer: B. PPO

15. A reason a claim may be rejected at the pharmacy is:

  • A. Drug expiration date
  • B. Incorrect patient insurance ID
  • C. Lack of refrigeration
  • D. Absence of a pharmacist
    Correct answer: B. Incorrect patient insurance ID

16. Insurance premiums are:

  • A. One-time payments for drugs
  • B. Monthly payments for insurance coverage
  • C. Amount reimbursed to the pharmacy
  • D. Pharmacy discount offers
    Correct answer: B. Monthly payments for insurance coverage

17. A “step therapy” requirement means:

  • A. The patient must take steps at home before medication
  • B. Patients must try less expensive drugs before expensive ones
  • C. Drugs are administered in steps
  • D. Pharmacy must confirm walking ability
    Correct answer: B. Patients must try less expensive drugs before expensive ones

18. The BIN number on an insurance card identifies:

  • A. The patient’s billing address
  • B. The pharmacy license number
  • C. The insurance company’s processing system
  • D. The number of prescriptions allowed
    Correct answer: C. The insurance company’s processing system

19. The PCN on an insurance card is used to:

  • A. Identify patient allergies
  • B. Track prescription usage
  • C. Route claim to appropriate processing center
  • D. Authenticate the prescription
    Correct answer: C. Route claim to appropriate processing center

20. If a patient’s insurance doesn’t cover a drug, the pharmacist should:

  • A. Cancel the prescription
  • B. Suggest over-the-counter alternatives
  • C. Contact insurance or prescriber to explore options
  • D. Demand cash payment only
    Correct answer: C. Contact insurance or prescriber to explore options

21. Which of the following is typically NOT included in prescription insurance plans?

  • A. Over-the-counter drugs
  • B. Generic medications
  • C. Brand-name drugs
  • D. Formulary maintenance medications
    Correct answer: A. Over-the-counter drugs

22. What is the role of the Group Number on an insurance card?

  • A. It identifies the patient
  • B. It links to a specific employer or plan group
  • C. It’s used for patient birthdates
  • D. It defines medication cost
    Correct answer: B. It links to a specific employer or plan group

23. A grace period in prescription insurance refers to:

  • A. Delay in starting treatment
  • B. Extra days for payment before cancellation
  • C. Trial period for new medications
  • D. Pharmacy processing time
    Correct answer: B. Extra days for payment before cancellation

24. What is a common reason for a prior authorization delay?

  • A. Incomplete paperwork or lack of justification
  • B. Busy pharmacy
  • C. Slow computers
  • D. Lack of patient contact
    Correct answer: A. Incomplete paperwork or lack of justification

25. When a patient has both private and public insurance, which usually pays first?

  • A. Medicaid
  • B. Medicare
  • C. Private insurance
  • D. Veterans Affairs
    Correct answer: C. Private insurance

26. “Out-of-network” means:

  • A. Medication not in stock
  • B. Provider or pharmacy not under patient’s plan
  • C. Data connectivity issue
  • D. Multiple claims submitted
    Correct answer: B. Provider or pharmacy not under patient’s plan

27. A “formulary exception” is:

  • A. A banned medication
  • B. Permission to cover a non-formulary drug
  • C. A discount program
  • D. Over-the-counter offer
    Correct answer: B. Permission to cover a non-formulary drug

28. Copay cards are provided by:

  • A. Pharmacists
  • B. Government agencies
  • C. Drug manufacturers to help with brand-name medication costs
  • D. Insurance billing companies
    Correct answer: C. Drug manufacturers to help with brand-name medication costs

29. Medicare Part D covers:

  • A. Hospital stays
  • B. Durable medical equipment
  • C. Prescription drugs
  • D. Routine dental care
    Correct answer: C. Prescription drugs

30. A patient’s coverage “lapse” means:

  • A. Temporary change in dosage
  • B. Interruption in insurance coverage
  • C. Pharmacy shut down
  • D. Return to previous therapy
    Correct answer: B. Interruption in insurance coverage

31. Formularies are maintained and updated by:

  • A. Pharmacists alone
  • B. Government regulators
  • C. Pharmacy and therapeutics (P&T) committees
  • D. Wholesalers
    Correct answer: C. Pharmacy and therapeutics (P&T) committees

32. Coinsurance is defined as:

  • A. A fixed fee per medication
  • B. A percentage of the medication cost shared by the patient
  • C. A monthly membership fee
  • D. Cost of drug delivery
    Correct answer: B. A percentage of the medication cost shared by the patient

33. What is an insurance “claim”?

  • A. A payment made to pharmacy by patient
  • B. A request for reimbursement submitted to insurer
  • C. A returned prescription
  • D. A legal complaint
    Correct answer: B. A request for reimbursement submitted to insurer

34. Drug discount programs are often used:

  • A. By wholesalers
  • B. To replace prescription insurance
  • C. To provide cost savings for patients without insurance
  • D. To reduce prescriber workload
    Correct answer: C. To provide cost savings for patients without insurance

35. An “adjudicated” claim means:

  • A. Denied for fraud
  • B. Returned to prescriber
  • C. Successfully processed by the insurer
  • D. Hand-delivered
    Correct answer: C. Successfully processed by the insurer

36. Which part of the Medicare program covers physician services?

  • A. Part A
  • B. Part B
  • C. Part C
  • D. Part D
    Correct answer: B. Part B

37. Medicaid is designed to provide coverage for:

  • A. Military families
  • B. Low-income individuals and families
  • C. Business owners
  • D. Foreign travelers
    Correct answer: B. Low-income individuals and families

38. “Tier 4” medications on a formulary typically involve:

  • A. OTCs
  • B. Preferred brands
  • C. Specialty or high-cost drugs
  • D. Vaccines only
    Correct answer: C. Specialty or high-cost drugs

39. A pharmacy technician’s role in insurance includes:

  • A. Diagnosing patients
  • B. Approving medical procedures
  • C. Entering insurance information and resolving rejections
  • D. Writing prescriptions
    Correct answer: C. Entering insurance information and resolving rejections

40. The maximum annual amount a patient pays before full coverage is:

  • A. Premium
  • B. Co-pay
  • C. Out-of-pocket maximum
  • D. Step therapy limit
    Correct answer: C. Out-of-pocket maximum

41. Tiered formularies categorize drugs based on:

  • A. Color
  • B. Strength
  • C. Cost and coverage level
  • D. Alphabetical order
    Correct answer: C. Cost and coverage level

42. A patient assistance program (PAP):

  • A. Hires personal nurses
  • B. Offers discounts or free medications from manufacturers
  • C. Tracks prescriptions
  • D. Issues insurance cards
    Correct answer: B. Offers discounts or free medications from manufacturers

43. Insurance claim processing time typically depends on:

  • A. Patient illness
  • B. Type of drug
  • C. Real-time electronic systems
  • D. Color of prescription
    Correct answer: C. Real-time electronic systems

44. An insurance “formulary alternative” is:

  • A. A brand-name drug
  • B. A similar drug preferred by the plan
  • C. A rejected drug
  • D. A non-FDA product
    Correct answer: B. A similar drug preferred by the plan

45. When should a pharmacist contact the insurer directly?

  • A. To request lunch discounts
  • B. To update patient allergies
  • C. To resolve claim rejections or clarify coverage
  • D. To increase co-pay
    Correct answer: C. To resolve claim rejections or clarify coverage

46. Mail-order pharmacy is an option for:

  • A. Emergency prescriptions
  • B. Long-term maintenance medications
  • C. Controlled substances
  • D. Single-dose antibiotics
    Correct answer: B. Long-term maintenance medications

47. What does “CMS” stand for?

  • A. Clinical Medical Services
  • B. Centers for Medicare & Medicaid Services
  • C. Care Management Software
  • D. Chronic Medication Solutions
    Correct answer: B. Centers for Medicare & Medicaid Services

48. The DAW code on a claim indicates:

  • A. The patient has no allergies
  • B. Drug Adverse Warning
  • C. Dispense As Written—no substitution allowed
  • D. Denied Access Warning
    Correct answer: C. Dispense As Written—no substitution allowed

49. If a medication is not listed in the formulary, it is considered:

  • A. Preferred
  • B. Covered
  • C. Non-formulary
  • D. Copay-free
    Correct answer: C. Non-formulary

50. Accurate processing of prescription insurance claims improves:

  • A. Marketing
  • B. Patient access to therapy and reduces costs
  • C. Drug development time
  • D. Pharmacy branding
    Correct answer: B. Patient access to therapy and reduces costs

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