Our guide to insurance coverage
In some cases, insurance covers the expense of hair replacement systems
If you are considering our services because of a medical issue, you may be covered through your insurance. Inquire with your insurance company and within their benefit booklet, which should have been given to you by your insurance carrier. This should list in detail all of the covered expenses under your particular plan. Look for the section titled “covered expenses” relating to “prosthesis” or “prosthetic devices” and see if your insurance will cover any or all of your expenses.
Here are our tips for navigating the insurance process
If you are covered by insurance, obtain a written prescription provided to you on an actual prescription form. Make sure that the diagnosis code or codes are included. This is very important to achieve insurance coverage!
Request a detailed written letter from your doctor explaining the extent of the (expected) hair loss, and the mental distress that you are or will be experiencing. Ask your doctor to use words as “cranial prosthesis” and “full coverage prosthesis.”
If you already are facing hair loss, have a picture taken of yourself showing your hair loss, thereby establishing that your claim is not for cosmetic purposes.
Ask us for a sales receipt or invoice with the wording: “Full Cranial Prosthesis”. We are happy to oblige you to ensure your insurance covers the cost.
Compose and write a letter that explains the personal emotional effects that hair loss has on your life. Be persuasive in arguing that a cranial prosthesis is just as medically necessary as a prosthetic limb or breast – it replaces a body part – hair.
If you feel comfortable involving your employer, ask them to write a letter explaining the importance of you being comfortable and secure with your appearance at your job!
Note! Make a copy of all the information sent to your insurance for your own records or let us help you make sure to have all that is needed.
If you purchase your hair prosthesis through us, please contact us so that we can provide you with an Invoice and the correct information for mailing to your insurance carrier.
We will help you with as much as we possibly can!
The following is a list of insurance companies that may cover cranial prosthesis. It will all depend on your individual plan.
- John Hancock Insurance Company
- Metropolitan Life (80%)
- Blue Cross Blue Shield (80 to 100%)
- Metropolitan Educator of New York (80 to 100%)
- Prudential Life Insurance (80 to 100%)
- C.I.G.N.A. Emerald Health Network (100%)
- Med Choice Provident Mutual (80%)
- Equitable Life Aetna (80%)
- Midwest Benefits Corp
Important: If your claim is denied you still have options
If your insurance company denies insurance coverage, you can request a written statement as to why the claim was denied. It could be that the information provided was not sufficient. If you did provide the appropriate information, but your claim was still denied, you can appeal by sending a letter to your insurance claims department. Request the decision to be reviewed by their medical review board.
Please note, we highly recommend you keep copies of all of your documentation and invoices for tax-exempt purposes. Portions of unpaid items by insurance may also be tax-deductible.
If you find that you get nowhere with your insurance company you might want to file a complaint.
The following link is to the Illinois Department of Insurance. You can fill out the form and upload directly: click here to download form.
You will need to include copies of all of your correspondence with the insurance company.
If you do not have insurance, you may qualify for a grant or voucher
NAAF’s Ascot Fund
NAAF’s Ascot Fund is a financial assistance program to help adults and children with Alopecia Areata purchase a hairpiece. The maximum amount awarded is $500, and the applicant needs to be able to pay any balance beyond the awarded amount.
You are eligible for the ascot fund if you meet the following requirements:
- Have been diagnosed with Alopecia Areata by a dermatologist or doctor
- Are unable to purchase a hairpiece due to financial challenges
- Are not already in possession of the hairpiece for which you are applying
OR have not already paid for the full balance of the cost of the hairpiece
For more information visit www.naaf.org.