Question:
Is Medically Necessary needed on my referral?

"medically necessary" will it affect approval with my insurance. My PCP doctor said I was a good canidate, but refused to put medically necessary to my insurance company. He did refer me to the surgeon though.    — [Anonymous] (posted on March 4, 2002)

March 4, 2002
It depends on what your insurance requires. They probably don't need it for the referral, but might need it for you ot have the surgery. You need to look at your insurance book and see.
   — garw

March 5, 2002
I'd imagine it all depends on the insurer. I called my HMO to get the details of exactly what they'd need from my PCP, and they said the request for authorization was enough, she doesn't have to write a separate letter of medical necessity. I can't guarantee YOUR insurer's policy, but basically, mine said if the doctor refers, they assume it's medically necessary without that being explicitly stated. :)
   — Heather W.