In medical benefits, who approves non-emergency health care?

• A. The employer
• B. The commission
• C. The insurance company
• D. The employee's treating doctor

Answer: (D)

The key idea is who determines medical necessity and authorizes non-emergency services within a medical benefits plan. The treating physician is the one who evaluates the patient, determines what care is medically necessary, and approves the non-emergency treatment. The insurance company may handle preauthorization requirements and payment decisions, but the authority to approve the actual medical services rests with the employee’s treating doctor. The employer is typically the plan sponsor, not the decision-maker for medical care, and a regulatory body’s role is broader oversight rather than routine approval of services.