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Insurance denial
I was diagnosed with Alopecia in January and twice now my insurance has denied me to see a dermatologist. They keep saying the Alopecia is cosmetic. I am a mother of one and have no extra money to even buy a wig let alone pay for a dermatologist out of pocket. I need all the help I can get. In 4 months I have already lost 95% of my hair on my head as well as hair on other parts of my body. If anyone knows how or where I can get help with a wig and or doctors please let me know.
Replies to This Discussion
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Permalink Reply by Cinder B. Rand on
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Hi Nicole
Wow I am so sorry to hear that they are denying your visits to the doctor. Can you find out if your doctor can write it under a different code for insurance purposes? Sometimes they are just entering it wrong but I am not sure about all of those details. I would also look for some support groups in your area. They may also be able to help you with finding a clinic that can help to work with you and also help you with having a piece donated to you. I am so sorry that you are going through this. As if it is not enough just to get this disease but also to have to deal with all of the insurance, pieces, eyebrows, lashes and everything else. Again I am so sorry and feel free to write me and I am more than happy to try to come up with ideas. We folks need to be creative about this. My best to you Peace Cinder
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Permalink Reply by Patricia on
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I think instead of wig if you request a hair prosthetic. I went down that route of trying to get a wig and I gave up. Do you need a.referral to.dermatologist? If.not, I agree with Cinder about coding. Talk to the doctor or staff person in billing about this. Someone there has to have answers for you. Good luck!
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Permalink Reply by Ellen on
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Hi, Nicole,
I had AA in 2002-2003 and it grew back but came back again in 2008 as AU , From your description it looks like that's where you are heading, too. Sorry to hear about your problems.
I did not have issues with insurance (knock on wood) in either episode of Alopecia. However, I know that there is always process of arbitration with any insurance and you can file appeals. Make sure your primary doctor will write a strong supporting letter on your behalf. I had it done when I needed the insurance company to pay for the wig. They probably would have paid anyway, but I was not going to take chances. There is a ton of information on internet and even without that, I am sure that you can put together a compelling letter - how this affects your emotional state, job search, gets you depressed, etc..
I hope that someone else on this forum can point out to other ways to make a compelling case - maybe there are advocacy groups that can also write on your behalf. This may be also very helpful if your ins. company gives you hard time with the wigs as well.
BUT....here are my two cents :
Cent # 1 - Go to see an endocrinologist, if you have not done it already - it could be thyroid. He could also give another letter to the insurance company in your support.
Cent # 2 - Not to give you a medical advice, but there is nothing except steroids that dermatologists offer. I did not even go to see one after I got AU, I jsut went to the endocrinologist. With steroids, IMHO, the cure is worse than the problem. Steroids are absolutely not the way to go for me.
I found my ways to cope. I have gorgeous wigs, learned to do makeup very well and recently did amazing tattoos on my eyeline and eyebrows - problem solved. Too bad you live far from where I am - the lady is in NY.
Cannot help you with the wig, though - it's from a local shop and I don't think they do mail orders. I wear mostly Renee of Paris synthetic wigs which are highly customized in this shop.
Get a strong support system, and just live your life. You will have ups and downs, but if you are otherwise healthy, that's a blessing.
Wish you all the best.
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Permalink Reply by Dorothy Louise Russell on
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there is a place I just don't remember the name of it. When I do I will leave it here for you. There can help you if you need a wig for free.
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Permalink Reply by Marieca on
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Sorry to hear about this. As the other ladies said, you want to make sure that your dermatologist is coding your diagnosis correctly. You may also want to she if your insurance covers hair prosthesis. If so, that will pay most or all of the cost for your wigs. Good luck with everything I pray you geT everything you need. Please feel free to message me if you want to talk or have questions as well!
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Permalink Reply by Tim Irvine on
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Cindy,
Here is some info from the naaf. I hope you find this helpful
http://www.naaf.org/site/PageServer?pagename=just_diagnosed_gettreat
Keep the faith and let us know what happens. Tim
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Permalink Reply by MariaR. on
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Dear Nicole,
I have struggled with AA all my life, and now I have AU. Here is my take: since I developed this disease as a child, it has always been a preexisting condition. Until the past two years, when I finally got great insurance, my disease was never covered. Still, I always treated it. In my experience, dermatologists charge radically different amounts. I wouldn't be afraid to call them up and ask them what they charge. Also, as someone who has frequently been on medication, it's the lab work that costs the most, and I found a doctor who only does it when necessary. There are more treatments than steroids out there (sorry to contradict the earlier poster, but it's true), but it is correct than many doctors won't prescribe them. You have to find a doctor that is knowledgeable about this disease and willing to fight it with you, providing that's what you want. For myself, I now have lost all my hair, but I think I would have lost it years ago without the help of certain awesome doctors. I'm still willing to try new things because I want hair, but I realize it probably won't work. For me, regrowing all of my hair this year thanks to medicine was awesome. However, seeing it all fall right back out again was devastating. You have to decide what's right for you.
As for wigs, even with my great insurance, they're not covered. I think it's very rare for insurance to cover wigs. I'm a graduate student, so I don't have much money, but I now have bought two wigs that were close to $2000. The first one I was not fond of; the second gave me my life back. Even if you can't really afford it, I would suggest buying a wig that makes you feel beautiful and confident. I don't know where you are located, but if you are in the Midwest, I would be happy to point you to some places.
Good luck with everything.
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Hi Maria...read your post and was wondering where in the Midwest would be a good place for a wig. AU for about six months now and trying to deal with this is hard.
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Permalink Reply by Classical Anne in NC mountains on
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Thanks for sharing that helpful link with us.
Anne
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Tim, Thanks for sharing that helpful link with all of us. It's hard enough dealing with this condition, emotionally and physically. It should not also be hard getting insurance coverage.
Anne
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Permalink Reply by jlkramer on
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Message me your address and I can mail you a wig - worn once, I just prefer myself bald I guess. The transition period is tough...I would keep pushing with your insurance as well- there are many studies out there proving that this is not a cosmetic issue.
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Hi Nicole,
I am so sorry to hear about what you are going through. I am a dermatologist and am happy to help you however I can. Start by going to your primary care doctor. In my experience, the insurance won't necessarily cover a visit with me, but they don't usually deny a visit for alopecia or labs with the primary care doctor. Ask him or her to order blood work including a complete blood count, ferritin levels, and thyroid function tests including a thyroid peroxidase antibody. How are you feeling? Have you had a decrease in energy? Have you had any change in weight? Did you have surgery, give birth, or have a major emotional stressor a few months prior to the onset of your hair loss? Are you having any other symptoms? I have found that if I can code for other symptoms (including seborrheic dermatitis- an itchy, flaky scalp), I can avoid the insurance denial. Please let me know if there is anything I can do to help. I know how stressful this is and wish you the best.
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