Question

Excellent Health Plan Unknown State University Prime Care Excellence Member Name: Jane Doe Effective Date: 01/01/20xx Member ID: EDQY43211904 Group No: 1730912 RX Bin/Group 15004 In-Network Member Responsibility: Primary $30 Specialist $70 PT/OT/ST/Chiro $50 BH, SU $50 Urgent Care $85 $15 Generic $25 Name brand, preferred $50 Name brand, nonpreferred a. What is the name of the health insurer? b. What is the name of the subscriber/insured? c. What is the group number? d. What is the RX Bin/Group number? e. What is the cost-sharing for a generic drug? f. What is the cost-sharing for a brand name preferred drug? esc

Answer 1

a.The name of the health insurer is Unknow State University, Prome care excellence

b.The name of the subscriber is Jane Doe

c.The group number mentioned here is V730912

d.The RX Bin or Group number is 15004

e.The cost sharing of generic drug is $15

f.The cost sharing of brand name preferred drug is $25

g.The c8st sharing for brand name non preferred drug is $50

h.The cost sharing for in network primary care visit is $30

i.The cost sharing for in network specialist visit is $70

j.The cost sharing for in network ED is $25

k.The cost sharing for in network behaviour health visit is $50

l.The cost sharing for an in network urgent care visit is $85