The Definition of Medical Necessity in Health Insurance
Table of ContentsView All View All Table of Contents Criteria Medical Uses of Marijuana Understand Your Right to Appeal Health insuranceplans provide coverage only for health-related services that they consider to be medically necessary. This article will explain what medical necessity means and how health insurance plans determine whether a particular service is considered medically necessary. Keep in mind that “covered” doesn’t mean the health plan pays for it. You still have to pay your required cost-sharing—copay, deductible, and/or coinsurance—before the health plan starts to pay any of the cost, even for covered services....