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option is not available to them, they may qualify for the previously mentioned CHIP or Medicaidbased on their household income. (Healthcare.gov, 2020) Similar to the U.S., a Japanese child can be covered under their parents Social or Employee’s Health Insurance. This insurance is offered to full-time employees by their employers. If this is not an option, they may be covered by the previously mentioned NHI. Children who are insured by Social Health Insurance or NHI can also receive a Free Medical Care Certificate which allows them to receive medical treatment and medications free of cost. (Japan Health Care Info, 2020)A2A. Coverage of MedicationsMedication coverage in the United States varies greatly based on insurance provider. Insurance providers may even choose to offer additional coverage or discounts on generic or non-formulary medications versus the name brand option. Insurance providers may also partner with pharmacy chains to offer additional coverage for certain types of medications. (The Common Wealth Fund, 2020) In Japan, the medication coverage follows the same percentage as the general health insurance coverage. Citizens are responsible for 30% of medication costs while the other 70% is covered by insurance. However, there are other programs in place such as the previously mentioned Free Medical Care Certificate which covers the cost of medications forchildren. (Japan Health Care Info, 2020)A2B. Referral to See a SpecialistUpdated on 6/15/2018
ORGANIZATIONAL SYSTEMS TASK 3 4In the United States, if you need to see a specialist, you must follow the requirements of your insurance provider. Some providers will require a referral from your primary care provider and others will not. The same applies to coverage of the specialist visit. Some insurance providers will require you pay a co pay at the time of the appointment before seeing the specialist while others do not. The out-of-pocket expense of the appointment will vary by insurance provider and insurance plan. (The Common Wealth Fund, 2020) In Japan, the same percentage of coverage applies to specialist visits, the citizen covers 30% while insurance covers the remaining 70%. Though referrals are not required by Japanese insurance providers, there maybe an additional fee charged to patients who visit a specialist without a referral. (The Common