Definitions for "Medical necessity"
A phrase used by insurance companies and 3rd party payers to describe the equipment and services a patient requires for health and safety needs. Insurance companies and 3rd party payers usually only provide equipment and services that meet medical needs, as opposed to educational or social needs.
Services/procedures which are approved in accordance with recognized medical standards as effective and appropriate and are essential to retard, reduce or eliminate an impairment.
Determination made by an insurance company that surgery is necessary to save your life, not necessarily just for your well-being.