Navigating the journey with trichotillomania can be challenging, especially when it comes to finding ways to manage its impact on your daily life. One such challenge might be obtaining insurance coverage for a wig, which can be a crucial part of your self-care routine.
In this article, we'll guide you through the steps to try to secure insurance coverage for a wig if you have trichotillomania. We'll provide tips on how to communicate with your insurance provider, what documentation you'll need, and how to advocate for yourself effectively.
Our goal in sharing this information is so you'll be equipped with the knowledge and confidence to seek the support you deserve.
Understand
Your Insurance Policy
The first thing you need to do is understand your insurance policy. Not all insurance plans cover wigs, but many do if the hair loss is due to a medical condition like trichotillomania. Check your policy documents and contact your insurance provider to see if they cover wigs under durable medical equipment (DME) or prosthetics.
If your medical insurance does not cover DME equipment that would help you manage TTM, shop for one that does.
Be sure to politely ask your current insurance company if they have a list of plan providers who do. (They may not but it will let them know you are looking for a new insurance plan.)
You'll need a prescription from a healthcare provider stating that the wig is medically necessary. Here’s how to get it:
Schedule an Appointment: Make an appointment with your doctor or dermatologist. Explain your condition and why you need a wig.
Medical Documentation: Your doctor will need to document your diagnosis of trichotillomania and the impact it has on your daily life.
Prescription: Ask your doctor to write a prescription for a “cranial prosthesis” (the term often used for medical wigs) and include your diagnosis in the notes.
Look for a reputable wig supplier who accepts insurance. Some suppliers specialize in medical wigs and have experience working with insurance companies. Make sure they can provide the necessary documentation for your insurance claim.
Before submitting your claim, gather all required documents:
Doctor’s Prescription: Ensure it states the wig is medically necessary due to trichotillomania.
Invoice or Receipt: Get an itemized receipt from the wig supplier.
Letter of Medical Necessity: Some insurance companies require a letter from your doctor explaining why the wig is needed.
Now it’s time to submit your claim to your insurance company. Follow these steps:
Claim Form: Fill out your insurance company’s claim form. You can usually find this on their website or by contacting their customer service.
Attach Documents: Include the doctor’s prescription, itemized receipt, and letter of medical necessity.
Submit: Send your claim form and documents to the address provided by your insurance company. Some may allow you to submit claims online.
After submitting your claim, follow up with your insurance company to ensure they received all the necessary documents. Keep copies of everything you submit for your records.
If your claim is denied, and your insurance plan does cover wigs under cranial prosthesis, don’t give up. You have the right to appeal.
Here’s how:
Request an Explanation: Ask why your claim was denied.
Gather Additional Information: Sometimes, additional documentation from your doctor can help.
Submit an Appeal: Follow your insurance company’s appeals process, which is usually outlined in your policy or on their website. If this denial continues after you have followed the process, contact your state’s insurance commissioner for assistance.
Getting a wig covered by insurance when you have trichotillomania can be a complex process, but it’s worth the effort. A wig can significantly improve your quality of life and self-confidence while you are healing from hair pulling.
In our self-help course, UnTrick Yourself, HFHP offers a free directory of cosmetic specialists who can assist you with this process as well as other hair care services!
