Mark Cuban Asks Why Can Insurers Deny Care as 'Medically Unnecessary' But Aren't Required to Carry Malpra
Benzinga
Last updated: May 25, 2026
The phrase "medically unnecessary" is a major point of contention in healthcare, allowing insurance companies to deny coverage for treatments. This leads to significant patient frustration and concern about health outcomes.
The phrase "medically unnecessary" empowers insurers to deny coverage for necessary medical services, impacting patient care decisions.
Insurers make these decisions through internal reviewers and standardized guidelines, often requiring prior authorization.
Critics argue this system allows insurers to second-guess doctors with less accountability than physicians, who are liable for malpractice.
The Employee Retirement Income Security Act (ERISA) limits state-level negligence claims against health plans, reducing insurer liability.
This imbalance, coupled with rising healthcare costs projected to be over $955,000 for a couple retiring, exacerbates financial and health anxieties for Americans.
Mark Cuban's critique highlights this system's flaws, resonating with many who have experienced coverage denials and their negative health consequences.
Cuban's advocacy aligns with his broader efforts through Cost Plus Drugs to increase transparency and reduce hidden costs in healthcare.
