Medically Necessary
Health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine.
Detailed Explanation
Insurance companies typically only cover services that are deemed medically necessary.
Practical Example
Tom's doctor recommended a specific surgery for his back pain. His insurance company reviewed the request and determined that the surgery was medically necessary based on his medical history and the established guidelines.
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