|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
Get Email Notifications When This Forum Updates or Subscribe With RSS
This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.
Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.