Why did my health plan say a drug or service isn’t medically necessary?
Sometimes doctors prescribe or recommend drugs and services that:
- May not be your best option
- Haven’t been carefully studied and proven to be safe and effective
When that happens, your health plan may say the medicine or service isn’t medically necessary. They may recommend a different drug or service that’s usually a safer and/or more effective option.
If you choose to use the medicine or service recommended by your health care provider you will have to pay for it yourself – unless your health plan can be convinced to cover it.
Contact OHA for help getting a recommended drug or service covered by your insurer.