Chelation Therapy for Off-Label Uses

This policy governs chelation therapy (e.g., EDTA, deferoxamine) and covers its use when proven effective for indicated diagnoses such as extreme heavy‑metal toxicities, transfusional iron overload, Wilson disease, lead poisoning, and select emergent uses. Coverage is limited to indications and dosing consistent with FDA labeling or nationally recognized compendia/guidelines, is subject to the member’s benefit plan (with Illinois fully insured plans effective 2025‑01‑01 containing specific pediatric provisions), and deems many off‑label uses—including Alzheimer disease, atherosclerosis, autism, diabetes, multiple sclerosis, and arthritis—experimental/unproven and not covered.

"Requested therapy is covered when proven effective for the relevant diagnosis or procedure based on generally accepted standards of practice."

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