who come from a low-income may qualify for Medicaid, or children's Health insurance program. The U.S. citizens that are unemployed insurance is based on household size and income, and this will determine what health coverage they are eligible for and how much help they will receive. In the U.S., retired adults over the age of 65 are covered by Medicare. In certain instances, a person may qualify for both Medicare and Medicaid, depending on specific qualifications (The Commonwealth Fund & International Health Care System Profiles, n.d.). A2A. Coverage of Medications In Japan, medications are just like their healthcare, and the patient pays 30%. In the United States, medication cost depends on health insurance; there is a copay the amount depends on the insurance company.
TASK 3 3 A2B. Referral to See a Specialist In Japan, there is no referral required to see a specialist. For the United States, it depends on the insurance coverage. Most insurance companies require a visit with their primary care physician to obtain a referral before being able to see a specialist. The specialist typically needs to be within the same network as the primary care physician in order for a higher rate of coverage to be paid. The same is true for people receiving Medicaid or Medicare. In order to see a specialist, the patient must then visit their primary care physician and obtain a referral. It can be more difficult for Medicaid recipients to obtain a referral. Most specialists refuse to accept a patient that has Medicaid due to the low reimbursement rates that they will receive.
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- Fall '18