Ethical considerations in health care benefits administration.
Defining the scope of coverage and limitations in various health plans has become an increasingly difficult and confusing issue. The historical shift to managed care has fundamentally altered the limitations on health care benefits. Because of the existence of "benefits exclusions," confusing issues have emerged in managed care situations. Fundamental fear of health care rationing has raised the awareness of the general public to the ethics of this issue. This article discusses the definitions and examples of certain types of health benefit exclusions and the ethical considerations related to such exclusions.
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William M. Mercer, Inc., USA.
D004991:Ethics, Institutional; D006264:Health Benefit Plans, Employee / Q000458:organization & administration / Q000592:standards*; D015276:Health Care Rationing; D006301:Health Services Needs and Demand; D019458:Insurance Coverage; D008134:Long-Term Care; D008329:Managed Care Programs; D010559:Personnel Management / Q000592:standards*; D012456:Salaries and Fringe Benefits; D014481:United States