Insurance Coverage Information For Patients

The single most important thing to remember if you want your insurance carrier to cover the cost of your MHP is to get a prescription from your doctor.

Insurance companies are only beginning to realize how helpful a medical hair prosthesis can be for someone who has lost their hair due to medical treatments or conditions. Hopefully, through persistence and education, we can change how insurance providers view medical hair replacement for the better.

The “wig” stigma

When you communicate with your insurance company regarding coverage for the cost of a medical hair prosthesis, make sure you refer to the product that way, and not as a “wig”. It’s true that a medical hair prosthesis is a special type of wig or hairpiece, but most insurance companies think of wigs only as stock items that are bought off the shelf in a wig shop. As someone suffering from medically related hair loss, you do not need this kind of wig. Insurance companies, on the other hand, often need a little help understanding that. If you are asked to explain the difference between an MHP and a wig, explain that a medical hair prosthesis is specially designed for medical hair loss and custom fitted to the individual’s head.

Some things to remember

• Insurance companies may reimburse their customers for the cost of a custom wig, but they do not pay the hair replacement company directly.
• Your insurance company may not cover “hair replacement” specifically, but if you are covered for prosthetics of any kind, then you have a good chance that your claim will be accepted.
• Most insurance providers do not cover the entire cost of a custom wig, but they should cover a substantial portion.
• Your insurance provider’s first response to your claim isn’t final. You can always try to appeal the decision, and if they’re being unreasonable, you definitely should.