PTCB Certified Pharmacy Technician (PTCE)Order Entry and ProcessingMedium
A pharmacy technician is calculating the cost of a prescription for a patient with a deductible. The medication's cost is $150. The patient's insurance plan has a $500 annual deductible, of which $400 has already been met. How much will the patient owe for this prescription?
- A$50
- B$150
- C$100
- D$200
Show answer & explanationAnswer & explanation
Correct answer: C. $100
The patient has a remaining deductible of $500 - $400 = $100. Since the medication cost ($150) is greater than the remaining deductible, the patient will pay the remaining deductible amount of $100. The remaining $50 of the medication cost will be covered by insurance (or subject to copay/coinsurance, but for this question, only the deductible is relevant).
Why the other options are wrong
- A. This would be the amount paid if the remaining deductible was $50.
- B. This would be the amount paid if no deductible had been met.
- D. This is incorrect; it might result from an arithmetic error or misunderstanding of deductible application.
Deductible Application
The amount a patient must pay out-of-pocket for healthcare services, including prescriptions, before their insurance plan begins to pay.
- Annual amount that resets.
- Patient pays 100% of costs until deductible is met.
- After deductible, copay/coinsurance typically applies.
Memory trick: Deductible's the Gate, Pay It First, Then Insure's Your Mate.