Did You Know?
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 a person requires a "cranial hair prosthesis" while undergoing Alopecia or cancer-related therapy, they may be eligible for reimbursement under their health insurance plan
If you file an insurance claim for reimbursement for a "wig" instead of a "full 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 is 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.
Get a prescription. A prescription for a medical hair prosthesis is necessary for most insurance claims. It may helpful to note on the prescription that it is "for the mental well-being of the patient" as well. And also quite helpful to include the ICD-9 code.
Get an invoice for your purchase. Some insurance companies require a copy of the receipt for the hair replacement piece to include their diagnosis code, so giving the code to them now will save time when they file their claim. Make sure the receipt says "Cranial Hair Prosthesis" and not "wig".
Include a written description. Even if it's prewritten. It may help to have a written statement that your prescription is for a custom made prosthetic and not a stock wig.
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.
Enclose a letter to the insurance company stating the necessity of prosthesis.
Some optional suggestions are:
These steps are for reference only. 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.
Have questions? Need more info? Send us an email at info@ruthsbeauty.com.
If a person requires a "cranial hair prosthesis" while undergoing Alopecia or cancer-related therapy, they may be eligible for reimbursement under their health insurance plan
If you file an insurance claim for reimbursement for a "wig" instead of a "full 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 is 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.
Get a prescription. A prescription for a medical hair prosthesis is necessary for most insurance claims. It may helpful to note on the prescription that it is "for the mental well-being of the patient" as well. And also quite helpful to include the ICD-9 code.
Get an invoice for your purchase. Some insurance companies require a copy of the receipt for the hair replacement piece to include their diagnosis code, so giving the code to them now will save time when they file their claim. Make sure the receipt says "Cranial Hair Prosthesis" and not "wig".
Include a written description. Even if it's prewritten. It may help to have a written statement that your prescription is for a custom made prosthetic and not a stock wig.
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.
Enclose a letter to the insurance company stating the necessity of prosthesis.
Some optional suggestions are:
- If possible, 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
- Take a copy of your prescription and paid bill to the American Cancer Society for partial reimbursement
These steps are for reference only. 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.
Have questions? Need more info? Send us an email at info@ruthsbeauty.com.
