Insurance Coverage Opportunity

Did you know?

If you require a ‘wig’, or the medical term “cranial hair prosthesis,” while experiencing Alopecia or, undergoing a cancer related therapy, you may be eligible for reimbursement under your health insurance plan?

If you need to wear a wig because of a medical condition such as Alopecia, or cancer-related therapies, the “wig” should be referred to as 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?

We are here to help you. We have the codes you will need to file your insurance claims.

Insurance Companies are realizing that cranial hair prosthetics are a necessity for those dealing with Alopecia or for people experience hair loss due to 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 “cranial hair prosthesis”. You will need to ask your physician to give you a prescription.

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 prosthesis, prosthetic devices or medical durable equipment. Most Insurance 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:  A. ask for a review by a medical review board, include the original claim B. ask for a written reply as to why the claim was denied. C. send a letter tot he 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.