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Covered services and medical necessity

Tuesday, October 6, 2009 at 11:58 PM

When you sign a health insurance policy, you get the lists of medical benefits such as tests, drugs, and treatment services you will get for free, or which your insurance company will partially pay for. These services are referred to as "covered services."
Of course you must be careful because it is easy to use something that isn't on the list, such as similar but deferent medications, in which case you will have to foot the bill yourself.

The term “medical necessity” covers anything that your doctor considers to be necessary; medical benefit, on the other hand, is something that your insurance plan has agreed to provide. Don’t confuse the two, and keep in mind that sometimes necessities aren’t covered by your medical insurance,

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