Medicare is a single payer with consistent coverage processes for prescription drugs
Medicare has three benefit programs, two of which cover prescription drugs
Medicare consists of four benefit programs, two of which cover prescription drugs
None of the above
20-25%
30-35%
25-33%
None of the above
The drug will likely have a prior authorization requirement
The drug's coverage will match the FDA approved label
The drug will likely be positioned on a specialty tier within the payer's formulary
All of the above
None of the above
True
False
True
False
Medicare Part D plan premiums, formulary design and patient cost share are all consistent across the US, based on Federal regulations
Medicare Part D plan premiums are consistent across the US, but each Part D plan can create their own formulary and cost share design
Medicare Part D formularies are the same across the US, but premiums and cost share may vary by plan
Medicare Part D premiums, formularies and patient cost share can vary from plan to plan
Medicare Part A
Medicare Part B
Medicare Part C
Medicare Part D
Medicare Advantage
MAPD plans
PDPs
FDA approval letter
Most recent ASCO abstracts
FDA approved product label
Health technology assessments
Clinical compendia publications
All of the above
None of the above
True
False
Comprehensive prior authorizations
Quantity limits (limiting the number of pills/tablets dispensed per month)
Formulary tier differentials
Differing patient copay or coinsurance
All of the above
The beneficiary will have medical benefits but not pharmacy benefits and will be required to purchase a separate Part D plan
The beneficiary's current Medicare Part A/B premium level will match the Medicare Advantage plan's premium
A beneficiary covered under Medicare Advantage cannot purchase a Medicare supplement/Medigap policy to cover the remaining patient cost share responsibility
All of the above
True
False
Community retail pharmacies
Specialty pharmacies contracted by payers
Long-term care and home health pharmacies
Physician offices (through onsite pharmacies or physician dispensing)
Hospital outpatient pharmacies (whether 340B eligible or not)
340B contracted pharmacies
All of the above
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