Hello Wig Company fam! Supriya here, but some of you may know me as @BaldieBoo! I’m honored to write this guest post for TWC. Today I will be sharing pro tips to help the medical hair loss community obtain reimbursement for wigs.
I’ve had Alopecia Universalis for a little over six years and have been requesting reimbursement from my health insurance since my very first wig.
Preparing To Submit for Reimbursement
Before I get into the nitty gritty, I must share some tea. Insurance tends to be a bit wishy washy when it comes to supporting the hair loss community. They may say silly things like, “We don’t provide coverage because it is a cosmetic condition.”
While that statement is rude (we all know the emotional impact of hair loss goes WAY beyond cosmetic), it is a stance they may use to deny your claim. I beg you, please don’t let that discourage you. Even if your insurance tells you they will provide zero coverage, I strongly urge you to try. Why?
I was told I’d receive $0 back for my very first wig. I submitted my claim anyway (YOLO!) and guess what?! I got a check back! It didn’t cover the full cost of the wig, but it did cover some.
In my opinion this is a win for multiple reasons.
Some money back is always better than none.
It means there is wiggle room with the denials.
It proves that being your own medical advocate can work out in your favor.
The wiggle room gives me hope that one day wig coverage will be totally normal. It's going to happen! Gotta keep the faith! :)
Information You Need to Submit Your Claim
When I submit my claims, I always include the following:
A copy of my cranial prosthesis receipt which includes a CPT code
It is very important that the receipt says cranial prosthesis and does not say wig. A cranial prosthesis is considered a durable medical device. That terminology decreases the odds of the claim being denied. When purchasing wigs from TWC, let them know you need a receipt in this format and they will make sure you are taken care of.
A W-9 from the company that I purchased my wig from
Insurance uses this information to enter your wig provider into their system. If the provider already exists in their system, you shouldn’t need this.
A cranial prosthesis prescription from my doctor that includes their NPI number and my diagnosis code
I typically get this from my dermatologist.
An insurance claim form from my insurance company.
Once I have all of these pieces in order, I fax them over and start the process.
What To Do if Your Claim is Denied
If the claim is denied, I ALWAYS call and fight for myself. Why? The worst thing that can happen is that they deny it again. The best thing that can happen is that you get some or all of your money reimbursed.
I truly believe everyone needs to be their own #1 health advocate, even if that means being a Karen and asking to speak to a supervisor. Since these aren’t typical claims, they may need to be sent to a unique department for processing. Frontline reps don’t always know that, but supervisors usually do. Keep fighting for yourself.
Sooner or later, this type of coverage will be business as usual for all health plans, but for now our voices must be heard. Good luck and may the odds be ever in your favor!