Insurance *MAY* Cover You
DID YOU KNOW? If a person requires a "cranial hair prosthesis" while undergoing
cancer-related therapy, they may be eligible for
reimbursement under their health insurance plan?
If you need to wear a wig because of medical reasons like Alopecia and
cancer-related therapy that the "wig" should be called a "cranial hair
prosthesis" for insurance purposes?
If you file an insurance claim for reimbursement for a "wig" instead of
a "cranial hair prosthesis" you will very likely be turned down?
Most insurance companies cover between 80 to 100% of a cranial
prosthesis?
Insurance Companies are realizing your cranial hair prosthesis are more
and more a necessity for those recovering from Alopecia and cancer
treatments.
Follow some simple guidelines to assure coverage, when it is available
through your insurance company.
Your physician should be able to supply all the details and make the
referral for the purchase of your "hair prosthesis". Ask your physician
to write a prescription for a "cranial prosthesis".
When receiving your hair prosthesis, have your stylist complete an
invoice for a "cranial hair prosthesis"--NOT a "wig"--and use the
following guidelines for filing an insurance claim:
CHECK the benefits of your insurance. There should be a section under
"covered expenses" relating to prostheses, prosthetic devices or medical
durable equipment. Most companies don't spell out exclusions so pay
attention to the actual coverage. this will help your case.
Make sure to complete the insurance form and have it signed by your
physician.
REQUEST that your physician write a "prescription" for a "full cranial
prosthesis" (not a wig) and a letter explaining hair loss and its
effects. That it isn't just for cosmetic reasons but for emotional
well-being as well.
Keep copies of your sales or invoices for your cranial prosthesis.
(Portions of unpaid items by insurance are tax deductible.)
ENCLOSE a letter to the insurance company stating the necessity of a
prosthesis.
Some optional suggestions are:
- include a letter from your employer,
- take pictures of yourself without hair,
- hand write a letter detailing the emotional effects that your
condition has had on your life,
- bring a copy of your prescription and paid bill to the American
Cancer Society for partial reimbursement.
If your insurance coverage is denied, you can appeal it by:
a. asking for review by a medical review board, include the original
claim
b. asking for a written reply as to why the claim was denied.
c. sending a letter to the claims department supervisor.
These steps are for reference. Remember to follow the procedures
outlined by your insurance company to receive the fullest benefits
possible. Most companies cover between 80 to 100%. Individual insurance
companies as well as the state insurance board (each state varies) may
have other or additional steps to complete.
If you don't have insurance, contact your state or county agencies. The
county department of social services offers medical assistance in most
states for individuals who meet certain income guidelines.