Will my insurance carrier cover an MHP?

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 an MHP, but they do not pay the hair replacement company directly.
• Your insurance company may not cover "hair replacement", "wigs", or "Medical Hair Prosthesis", specifically, but if you are covered for prosthetics of any kind, then you have a good chance that your claim will be accepted.
• Many insurance providers do not cover the entire cost of an MHP, 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.

Steps to follow

• Get your doctor to write you a prescription for a "medical hair prosthesis". You'll need this when you file your reimbursement claim. It may help to have the doctor write "for the mental well being of the patient" on the prescription.
• Ask your doctor for the ICD-9 code (also referred to generally as the diagnosis code). Mose insurance companies require this to be on the invoice for the MHP.
• Get an EOC booklet from your insurance company. This booklet should describe everything your insurance plan covers and how much they'll pay. Look up wigs and prosthetics.
• You know you need to do something about your hair, so book your free consultation at yourHAIRx right away, but contact your insurance company as soon as you are given your prescription.
• When you contact your insurance company, explain your medical condition and how it has affected your hair loss. Give them all the details surrounding the diagnosis, including the doctor's concern for your well being. Find out how much they will cover.