How can insurance companies cover some things that are most definitely NOT medically necessary but say things that are far more are not?

For example, hearing aids are not anywhere near fully covered because they're "elective"... so whether you can HEAR is elective, but whether you can mutilate your genitals to "change your sex" is necessary? wtf.

How can insurance companies cover some things that are most definitely NOT medically necessary but say things that are far more are not?
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