can be decreased. They also require that generic medications be sold for 20 to 50 percent less than the original brand. Also, the pharmacists are reimbursed a flat rate for medications so that
Star Rios C489 Task 3 there is no incentive for them to write more expensive medications (International Health Care System Profiles, 2016). When individuals are sick they make appointments with their different specialists. Some countries different insurances require referrals to see a specialist and some do not. In the United States Healthcare system in order to see a specialist the person seeking the referral needs to look at the insurance plan that they have and see if the plan requires a referral to see a specialist, if not then they can see the specialist without a referral. For example, the insurance plans labeled HMO need for the patient to see their selected primary care physician to obtain a referral to see the specialist. If the referral is obtained then it is given to the specialists’ office on the visit day to submit to the health insurance with the visits claim. Once the insurance receives the referral from the PCP then the insurance company should cover the visit based on plan details. Other plans such a Preferred Provider Organization don’t require the patient to select a primary care doctor and doesn’t require the patient to obtain a referral for the specialist visit ( Referral - HealthCare.gov Glossary). In the Switzerland healthcare system, the requirements to get a referral to see a specialist are that the patient usually isn’t required to get a referral from their doctor. Most of the insurance packages place a specialist visit to be covered under what they call secondary care. Secondary care is included and most don’t require a referral to see a specialist ( Swiss doctors: How to find and register with a doctor in Switzerland - Expat Guide to Switzerland, 2019). The coverage for preexisting conditions can vary from country to country. The US Healthcare system has a healthcare marketplace where people can purchase healthcare. All of the plans provided must cover the diagnosis and treatment for all preexisting medical conditions. The insurance company cannot reject the application based on the
Star Rios C489 Task 3 patient’s history. They also can’t raise the price of the insurance based on the patients preexisting medical conditions and they cannot cancel the insurance based on the patients’ health. The coverage for preexisting conditions in the Switzerland Healthcare system includes preexisting conditions meaning the insurance can’t deny the patient requesting insurance based on their medical history. This makes it much easier for citizens to access healthcare. The terms of this specific policy are mandated by law (The Swiss Also Have a Private Health Care System. But Theirs Works, 2017).
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