an additional expense to the individual. Some insurance companies offer prescription coverage for an added expense. Prescription coverage requires an individual to pay a co-pay amount for prescriptions and has maximum allowed coverage. Medicare has a maximum amount of coverage and once that individual exceeds that amount the individual is responsible for their prescriptions for the remainder of that fiscal year. The U.S. has one of the highest costs of prescription medications considered to other countries, like Great Britain.
ORGANIZATIONAL SYSTEMS & QUALITY LEADERSHIP TASK 3 D. Specialist Referrals The U.S. requires that the primary care provider refers patients to a specialist. The U.S. healthcare system will not pay for a specialist, unless they have an order from their primary care provider. Still, there are occurrences where their healthcare system may deny referrals to a specialist if they deem it is not warranted. Healthcare system providers may have their own set of standards of care and can vary significantly from one healthcare provider to another. In Great Britain’s healthcare system does not require a referral to a specialist. In Great Britain, the individual can see any type of physician that they want; they are not limited to a specific primary care provider. The wait times are about the same to see a specialist in both the U.S. and Great Britain. E. Preexisting Conditions The universal healthcare system does not have any seclusions for preexisting conditions. In the U.S. healthcare system, preexisting conditions used to exclude one from getting insurance. That was the case until the Affordable Care Act came into place. Since the Affordable Care Act, individuals are no longer being denied health insurance for preexisting conditions. They are required to pay a significantly higher rate/premium for insurance.
- Spring '16