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Permalink Reply by kastababy on March 10, 2008 at 12:34pm

It has been my experience that no matter what you call it, a MHP or a wig, until very recently, most insurance companies will NOT cover the cost of one, even if you are a cancer patient or undergoing chemotherapy. It is a battle that my parents and I have fought for 20 years. Even with the recent bills passed by Congress that require health insurance companies to cover MHPs and wigs, because of the wording of the law itself, insurance companies have yet another loophole to use to deny coverage. Most, if not all, major insurance companies require that you purchase your MHP or wig from what is known as a durable equipment medical supplier (DEMS). Here is the catch: Most DEMS do NOT carry MHPs or wigs and refer you to a wig shop for the product.

Now, this is what I was told by several wig shops here in Tennessee, where I live, and in fact, there is not a SINGLE DEMS within 1000 miles of the state of Tennessee that carries either MHPs or wigs in stock: Because there is such a proliferation of wig shops and places like Apollo Hair Systems and Hair Club and Bosley, a DEMS will not carry MHPs or wigs, and that I should go to a wig shop to get what I am looking for. Because of the contradiction, even though my insurance company will cover 80% of the cost if the DEMS is in network (which of course since they don't carry them it won't be), I am still paying out of pocket upwards of $1000 for my wigs.

Now, if you can point out how to close the loophole and get my insurance company to pay the money for my wigs, then by all means, share with everyone; however, I think that you have hit on a very sore subject with this particular discussion. I for one would like to hear other horror stories like mine and what you may or may not have done to get around it.

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Permalink Reply by Shemika on March 10, 2008 at 4:52pm

Hello, as you all may know from my about me section on my page, I carry lace wigs which are wigs made to appear as your own hair and they are great for hair loss clients. I cater to alopecia and other hair loss clients in my local area of Virginia Beach, Va. I go to their houses and consult them on my wigs in private so not to make them feel uncomfortable in the salon setting. I've been doing this for over 2 years now and over time have learned some things about insurance coverage. You guys are right, there is a certain term that is used for the insurance covereage and there are certain steps to be followed in filing your claim. See below for the information pulled from my site on getting your insurance to cover your unit. For more information on lace wigs please check out my site, google the term 'lace wigs', and also check out youtube.com for videos that people including myself have posted to show how they are applied and removed. Also if you have any questions that you can't find the answer to, please feel free to contact me personally at ladylacewigsandhair@gmail.com

Getting Your Health Insurance to Cover the Cost of Your Unit:
When requesting a prescription from your physician, the full lace wig should be referred to as a "full cranial prosthesis" which will then enable it to be covered under most medical insurance policies. Most insurance companies will cover between 80-100% of the cost for your full cranial prosthesis, while others may provide a partial reimbursement after your purchase has been made. However, if you request coverage for a ‘wig’, chances are your claim will be denied. So please make sure you request a "full cranial prosthesis".
Your hair prosthesis may also be a tax deductible medical expense, please be sure to check with your insurance provider to validate all statements documented here prior to purchasing your unit if you are not personally financially able to do so. Remember to request that your physician write a prescription for a "full cranial prosthesis" (not a wig) and a letter explaining hair loss and its effects. It is important that your physician states that it is not simply for cosmetic reasons but for emotional well being.
Steps to Follow:
• Check the Coverage on your insurance policy to see if it covers a ‘cranial prosthesis’.
• Request your physician to write a prescription for a "full cranial prosthesis" not a wig
• Complete any other insurance forms and be sure they are signed by your physician
• Ask your physician to also write a letter explaining your hair loss and its effects, including that your prosthesis is not simply for cosmetic reasons but instead for emotional well being.
• Keep copies of all of your documentation and invoices for tax exempt purposes
• Send an email to ladylacewigsandhair@gmail.com to request the “hair loss order form packet”. Review and sign the attached purchasing policy and be sure to keep the copy for yourself
• Fill out your order form using the instructions provided (be sure to check the Full Cranial Prosthesis box as I will ensure that your invoice will read correctly for tax exempt purposes).
• Calculate your costs correctly using the information provided throughout this packet
• Send in your completed and signed order form along with any other supporting documents or tools to P.O. Box 3515 Virginia Beach, Va 23454 by way of USPS certified mail and contact me with the tracking number
The above steps are for your reference. Good luck in obtaining insurance coverage for your unit!
Applying for a Grant or Voucher to Cover your Full Cranial Prosthesis (full lace wigs):
The National Alopecia Areata Foundation (NAAF):
NAAF has established the Ascot Fund. This special pre-purchase program provides financial assistance toward the purchase of a hairpiece to individuals who have alopecia areata and are struggling financially. To find out if you qualify, please contact them using the information provided below:
National Alopecia Areata Foundation
14 Mitchell Blvd.
San Rafael, CA 94903
or
PO Box 150760
San Rafael, CA 94915-0760
Phone: 415-472-3780
Fax: 415-472-5343
E-mail: info@naaf.org
Web site: www.naaf.org
American Cancer Society:
American Cancer Society has a program available to those who qualify to assist you in purchasing a wig. If your insurance does not cover the full cost of your wig or only covers partial cost of your wig, you may quality for an allotment through the American Cancer Society. The American Cancer Society will issue you a voucher up to $75 to help cover the cost of your wig. You must meet certain financial guidelines. You MUST apply for this voucher BEFORE you purchase a wig. It will not be awarded for pre-made purchases.
To inquire about getting financial assistance for your wig purchase, you can contact the American Cancer Society below:
American Cancer Society
Call 1-800-227-2345
Ask to Speak to Someone Re: Financial Assistance for a Wig Purchase

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Permalink Reply by Mama B on March 11, 2008 at 2:01pm

I currently have United Healthcare as my insurer. I'm not overly fond of them, BUT, they are one of the few insurance companies that will cover up to $500 toward a wig for alopecia, if you've met any deductibles you have. Now, you have to know how to work them for this, as when I first attempted, nobody there knew what the hell they were doing. First, I had to get a note from a dermatologist, stating that I had alopecia areata, and that a hair prosthesis was medically necessary for me. Then, I had to find someone in the customer care dept. (this took some searching!), who told me I had to request a "network exemption", as there were no wig facilities within 30 miles of me. Next, I had to get the insurance company to approve my choice of wig provider, who happened to be in another state, and have them enter them into their computer, so that they were now considered an "in-network" provider. The insurance company then gave me a 2 month time frame that I had to purchase a wig from this now approved vendor. When I finally submitted my bill for the wig to them, I had to go through all this explaining again with them, but because I had taken meticulous notes, written down names of everyone I had spoken to and kept all confirmation numbers, they FINALLY coughed up the $500. It was a very trying experience, but they did cover the wig.

I've found that the insurance companies that do say they'll help cover a wig, usually don't deal with this a lot, so you need to keep meticulous notes on who you've contacted, keep copies of every piece of paper you've sent them & have a lot of patience!!!!!!!

Tammy

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Permalink Reply by Shemika on March 11, 2008 at 2:44pm

This is fantastic information! I love the part when you say 'but because I had taken meticulous notes....', that was so cute!

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Permalink Reply by Daria on March 31, 2008 at 9:35am

I'm so glad I just read your posting! I also have United Healthcare and they denied my claim b/c I didn't have cancer. And I had submitted a note from my dermatologist listing the "full cranial prosthesis" and everything! Now I know I'm going to go back and see what I can do! Thanks so much!!!! :)

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Permalink Reply by Andrea on November 11, 2008 at 2:51pm

Hi. I'm Andrea.

I just called my insurance company.
They said without a cancer diagnosis I was out of luck.
Alas...

I did submit a formal complaint.

I really do want a vacuum prothesis, but know that without some help, it will never be.

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Permalink Reply by Yuko on March 30, 2009 at 8:58pm

I am insured through Tricare as my husband is in the Navy. According to Tricare,
"TRICARE covers one wig per beneficiary per lifetime, when the attending physician certifies that alopecia (hair loss) results from the treatment of a malignant disease (i.e., cancer), and the beneficiary certifies that he or she has not previously obtained a wig or hairpiece through the U.S. Government.

TRICARE does not cover hair transplants; the cost of maintenance, supplies or replacement of wigs or hairpieces; diagnostic or therapeutic methods intended to encourage hair regrowth; or wigs or hairpieces for hair loss caused by something other than treatment of a malignant disease."

What a bunch of bull :(

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