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Will my carrier pay?
Feb 11, 2013

My carrier, Equitable, pays for everything. I once had 15k in genetic testing.. all paid, everything is usually covered. Here is my question. About 10 yrs ago, I had bio-alcamid injected in my face in mexico, Now it is migrating and needs to be removed. If I did this in the US, do you think a doctor that specializes in this procedure, would get paid?

Response from Mr. Chambers

It certainly sounds like you have very broad coverage on your policy, but, without seeing the actual plan provisions, there is no way to tell what your carrier will do.

For it to be covered, it would have to be "medically necessary." That means it would harm your health in some way if not removed. It must be more than cosmetic.

You might get some clues by seeing the wording of any exclusion about medical treatment for cosmetic purposes. It would also be interesting to know if they covered the initial injection.

Study the contract, especially the exclusions. You may have to have the procedure before they can decide whether it's covered or not. You can call and ask, however, regardless of what they tell you, they dont have to stand by that since things can change once they see the actual claim.

I'm sorry I can't give you a better answer. Good luck, Jacques



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