Legal Question in Insurance Law in Florida

Biopsy on a lump in the breast.

I have a friend who had a mammogram which two lumps were found. She consulted a Physician and scheduled a biopsy. She was then told that the insurance does not pay for the biopsy and would have to pay $1800 out of pocket, which she doesn�t have. This is the same insurance that paid for the mammogram.

Is this correct, can an insurance company pay for a mammogram which reveals a lump and then on the advice of a Physician not pay for the biopsy on that lump?


Asked on 1/30/08, 11:51 am

1 Answer from Attorneys
Alan Wagner Wagner, McLaughlin & Whittemore P.A.

Re: Biopsy on a lump in the breast.

It depends on the terms of the insurance contract. Most policies would cover the mamogram and the biopsy -- but she should ask for the specific terms of the policy that the company relies upon in declining coverage.

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Answered on 2/03/08, 1:10 pm


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