If there is no prescription benefit however the full cost falls onto the

If there is no prescription benefit however the full

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If there is no prescription benefit however, the full cost falls onto the patient. In the United Kingdom, many are eligible for free prescriptions. This entitlement is granted to those over 60 years old, under 16 years old, full-time students between 16 and 18 years old, pregnant or previously pregnant within the last twelve months, have a valid medical exemption card, war pension exempt with accepted disability, are an NHS inpatient or qualify under various other acceptable situations as outlined the NHS coverage details (“Get help with prescription costs,” 2018). Outpatient prescription drugs are subject to a copay with NHS. A2B. Referral to See a Specialist Referral to specialists in the United States is dependent upon the individual insurance plan. With PPOs, you may simply make an appointment to see a specialist as these plans do not require referrals. POS Plans and HMOs require a referral from the primary care physician for specialist appointments. Requirements for referral with Medicare depends on the type of plan (PPO, HMO, POS). Medicaid, however, does not have any requirements for specialist referral. NHS specialist referrals are required to be obtained from the registered primary general practitioner (GP). The GP provides the letter of referral but is not required to follow the specialist’s recommendations. The referral process in England with private healthcare plans is individually determined by those companies.
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ORGANIZATIONAL SYSTEMS TASK 3 5 A2C. Coverage for Preexisting Conditions In the United States, insurance providers can not refuse coverage due to pre-existing conditions ("Pre-Existing Conditions," 2017). Private Insurance providers in England generally exclude coverage for pre-existing conditions while the NHS will not limit this coverage ("Private medical insurance in the United Kingdom," 2006). A3. Finance Implications for Healthcare Delivery Healthcare outcomes depend on the quality of care given to patients. Unfortunately, quality may depend on the incentive to providers. Bottom line, incentive typically is based on money. Since the NHS is government funded, wages for healthcare workers and incentive for quality given care is dependent upon the status of the economy in the United Kingdom. Free healthcare is not free. The financing must come from somewhere and it is the burden of the people to pay through taxes.
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