health-care

What to Consider in Health Care Policy Issues

There are many health care policy issues to consider, especially when choosing long-term care health insurance policies as well as child health care policies. Some individuals may find that their place of employment, union or professional organization provides a group health care policy that narrows down their choices and helps them to address those particular health care policy issues so that they are not surprised when filing a claim. Other individuals may have to find private policies, which means they have to narrow down the many companies on the market today and find just the right ones to meet their needs, which requires a lot of research and time.

Points to Think About

Individuals need to decide right from the start how much money they can afford on a health care policy and how many individuals need to be included in that policy. This is one health care policy issue that will help to narrow down the choices considerably. In addition to the number of individuals to be insured, the ages also matter, since there is usually some sort of pre-approval screening that may require a doctor's visit and professional screening in order for the approval to be given, which is usually the case for the elderly or anyone with previous health problems.

Once the individuals have narrowed the focus down to certain companies and certain policies, then they need to look at other health care policy issues such as what type of access they will have to doctors, hospitals and other health care providers such as adult day care centers, chiropractors and also dentists and vision care. An HMO policy requires the individuals to go to health care providers that are on their pre-approved list of providers, and also require that the individual get a referral from his primary care physician to see a specialist from the list. A PPO policy gives the individual more freedom of choice in providers, however, the individual gets better coverage if the provider is from the pre-approved list of providers.

Health care policy issues also include who is required to file the insurance claim: the individual or the service provider. In group health plans, the service provider usually files the claim, whereas in private health care insurance plans the individual is often responsible to file the claim, requiring time and knowledge of what is covered in the plan, including how to file if it is after hours or an emergency situation.