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.
