Getting Insurance Coverage for Wigs

Honor Yourself - Get What You Deserve
For those of you who may going through Chemotherapy treatments or are dealing with some level of emotion due to another condition, I know that this may be a trying time physically and emotionally right now and calling and dealing with reimbursement may seem too much and just another thing to have to deal with. Don't let that stop you from doing something for yourself that could ease some stress at the moment.

A hair piece you love can be, after all, as important as a medication you take to treat nausea. You wouldn't let yourself stay this way without doing something about it - the same goes for honoring yourself enough to get what is due you. FYI: A wig can also be a tax-deductible expense.

Be aware that not all insurance companies cover wigs; however, many do. Your reimbursement will depend on your particular policy. It's best to look into the details of your coverage before you go shopping for a wig so that you are well-informed about the amount of out-of-pocket expenses you will be responsible for.

Some insurance companies may pay up to 50 percent, and others, like Blue Cross which has recently changed its rules, may pay up to only $400. Many times, it really will depend on your policy.

There are no guarantees as not every company reimburses, but you should try.

Follow these steps for reimbursement:
1) Ask your insurer for their specific requirements. When you call to inquire - never say "Wig" - it's best to speak their language, by asking if you are covered for a "Cranial Prosthesis".

2) More and more health insurance companies today cover part or all of the cost of the wig if your doctor writes a prescription for a "Medical Cranial Prosthesis", which you will submit to your insurance company along with the receipt from the wigmaker, hair replacement center or wig store. Most stores know this process and will be happy to assist you. It's always good to call ahead of time to make sure the wig specialist you are visiting with is familiar with this process as you want to get reimbursed correctly without any mistakes from the start.

3) You will also need the specific diagnosis on your prescription. (For example: If your reason for needing a wig is due to Alopecia, Alopecia alone is not a diagnosis - you need to know what type. Make sure to ask your doctor to list this in his prescription)

 

4) Since insurance companies are currently overloaded with claims, I would expect a delay. I recommend staying in communication with them weekly so they get used to your name and claim. Dealing with insurance claims can be frustrating; take a deep breath and have some patience and you will attain your goals with them. If you let their process get to you, you will only put yourself through more stress. A few points to remember are:

5) When speaking with the insurance company, always write down the employee's name, the day and time of the call, and any additional notes, instructions or advice that were given.

6) When sending any paperwork always send it via certified mail so there is proof of your letter, as many times paperwork gets lost or misplaced. I can't stress to you enough that the more organized proof you have for your claim the better your chances will be in getting your claim through more easily. Have a specific place for all your information (a file folder or a specific drawer in the kitchen) as chemotherapy can sometimes make you feel disoriented.

Remember, it's best to contact your health insurance plan for authorization requirements for recipients in prepaid health plans.

Note: If you can't get or don't have coverage, call your local chapter of the American Cancer Society or your cancer center for assistance. They may even offer free wigs.

If you are offered a free wig, make sure it is really what you want. A woman may donate her wig because she seldom wares it or because she has had it for a very long time. Some salons and wig manufacturers donate new wigs for cancer patients. They may be styles or colors that didn't sell well or wigs that they have had in the warehouse for some time. They could be very good wigs that customers returned or exchanged. Make sure they are clean which you'll be able to tell by its overall look and feel and fairly good fragrance. Try to find out the original retail price. There is a wide range of quality in wigs - some are extremely cheap, poorly made and uncomfortable. Your local hairdresser should be able to advise you about the quality of a used wig.
CreatedHair.com is an approved provider for many insurance companies.

FYI:
Common code for Wigs = S8095
Healthcare Common Procedure Coding System (HCPCS) for wigs = A9282