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Beginner Exercises 1. Summary of Benefits and Coverage (Level 2-Understanding) Use figure 2.2 from the textbook to identify the cost-sharing components. Complete the accompanying table.

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Beginner Exercises 1. Summary of Benefits and Coverage (Level 2-Understanding) Use figure 2.2 from the textbook to identify the cost-sharing components. Complete the accompanying table. Question Answer What is the cost-sharing for a generic drug, network provider? What is the cost-sharing for a tier 2 drug purchased at an out-of- network pharmacy? What is the cost-sharing for a specialty drug, network provider? What is the cost-sharing for a network immunization visit? What is the cost-sharing for a network primary care visit What is the cost-sharing for a network specialist visit? What is the cost-sharing for an out-of-network primary care visit? What is the cost-sharing for x-rays provided by a network provider? What is the cost-sharing for outpatient surgery provided at a network facility? What is the cost-sharing amount for the surgeon fees for outpatient surgery provided at an out-of-network facility? 2. Managed Care Penetration in the US (Level 2-Understanding) Managed care organizations (MCOs) operate in every state. Kaiser Family Foundation (KFF) tracks and reports s penetration. Go to the organization's website (http://www.statehealthfacts.org) and click Health Insurance & Man Then choose one of the three categories with its associated pathways: Lars

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