*How to File for Insurance Reimbursement

Many people with Alopecia Areata are trying to convince insurance carriers to cover the cost of a prosthesis even when the law does not require it. Information from people who have succeed in obtaining insurance payments for hair prostheses or medical treatments has been compiled in NAAF’s Insurance Packet. NAAF will provide this packet upon request.

Here, in brief, are the steps we suggest you follow to convince an insurance carrier to cover the cost of hair prostheses or medical treatment:

• Check your benefits and covered expenses. Copy any page that specifically states that prosthetic devices (or treatments) are covered for alopecia areata or other types of hair loss.
• Complete the claim form.
• Obtain a doctor’s letter or prescription stating the need for a hair prosthesis or treatment.
• Obtain the “Quality of Life Investigation of Patients with Alopecia Areata” from NAAF, and include it with your claim. This report by NAAF grant recipients Drs. Wilma Bergland and Berna Remzi contains an outline that indicates the negative impact of hair loss from alopecia areata.
• Obtain receipt that says ‘hair prosthesis” and have the person who provides you with the prosthesis sign your insurance form.
• Take pictures of yourself without a wig or corrective eye makeup(pictures can also be used to emphasize why treatment is needed).
• Enclose a NAAF brochure describing alopecia areata.
• Provide a detailed personal account of the emotional effects of your alopecia areata (and discuss the costs of frequent hair prosthesis purchases).
• Ask your employer for a letter stating the importance of your general appearance, including your hair.

Prepare for Denial of Your Claim

• Speak with your plan administrator.
• Obtain a list of your rights as the Insured.
• Obtain a copy of your full contract.
• Know your contract.  Pay particular attention to exclusions for prosthetics (wigs may be excluded as cosmetic). If your policy does not spell out exclusions under prosthetics, this may help you win your claim. If your claim is denied as ‘not a covered benefit,’ write an appeal.
• As for a review by a medical review board
• Attach a copy of your original claim and all supporting materials.  Explain the difference between a wig and a prosthesis. Explain the functions of body hair: it protects the scalp from the sun; protects eyes from dust particles; regulates body temperature; filters particles from the nose and protects the skin.
• If you are undergoing treatment, explain again how this is NOT cosmetic treatment.
• Ask for a written reply (insurance companies resist writing anything that may be considered ‘bad faith’ in future court cases).
• Send your appeal to a claims supervisor or manager. If you don’t, the person who initially reviewed your claim may reject it again.

Consider Small Claims Court

• Keep all correspondence in preparation for this possibility.
• Do not reply on your memory.
• Insist on written confirmation from your carrier for all conversations.  Make sure this includes date, time and full name and title of the person with whom you spoke.
• You should follow up all conversations with your own confirmation letter, which you should supply to the insurance carrier. Make sure to document the date, time, and full name and title of the person with whom you spoke.

Contact Your State Insurance Commissioner

• You may file a claim against your insurance company through your state Insurance Commissioner’s office.

*NAAF Ascot Fund

NAAF’s Ascot Fund puts hair prostheses within reach! This special program was established thanks to an anonymous donor who wished to help adults and children with alopecia areata purchase a hairpiece. A small number of organizations offer assistance for hairpieces to children but not to adults, making this program the first we know of its kind. Over one hundred individuals have benefited from the fund since the start of the program in January 2004.

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 shown on the application,
• have not already paid for the full balance of the cost of the hairpiece.
  
  (The Ascot Fund is a pre-purchase program; reimbursements are not provided for any purchases paid in full either by credit card or other financial means).

The maximum amount awarded is $500. The applicant needs to be able to pay any balance beyond the award amount.

Please call NAAF at 415-472-3780 and ask them about the ASCOT Scholarship. 

To receive assistance in ordering your wig, please contact The Wig Emporium's customer service.

Ascot fund Testimonials

Dear NAAF Ascot Committee…

“I recently applied for assistance in purchasing a prothesis wig. Financially I could not afford to purchase one.  When I heard about your Ascot Fund I knew my dream to get a hair prosthesis would come true and it did! I can curl it, blow dry it and most of all let the wind blow it around without the worry of it coming off or the lining showing. It doesn’t itch and looks and feels 100% better!”

“Thank you for helping my dream to come true!”

“I would like to express my deepest gratitude and appreciation for you, the NAAF and the donor(s) to the Ascot Fund. This award will significantly alleviate the financial burden of purchasing a hairpiece. I am very grateful that I can purchase a hairpiece that makes me feel comfortably about my appearance. I hope I will be able to return the generosity in the future. Good luck with your continued work with the NAAF and thank you again.”

“I thank you so much for the financial help with my wig. After many years of cheap wigs and all the stares, laughing and ridicule, I finally feel as though I look like a normal human being”

“I am so glad that the support from your organization is right on time. The new look and feel of my new hair for going back to school where I’m studying culinary arts is just bliss”

“Thank you so much for awarding me the funds to purchase a new hairpiece. I was so delighted and thrilled when I received your timely response…. I am truly grateful to your organization and the help you have extended to me and my family”

“I am so grateful that there are programs and funds out there to help with this disease….I can never express how much I appreciated all of your help.”

“We have never had the funds available to be able to purchase a human hair wig. Your special Ascot Fund has made this possible for Sarah for the first time. She is so excited about being able to wear real hair on her head. To be able to curl it, cut it, twirl it in her fingers, blow dry it, and feel the wind blow through her hair are all things she has only dreamed of.”

“As I was preparing to begin law school in August, I always rule out natural hair wigs as they are so costly. Thanks to you and the NAAF, I will be able to style and play with a wig, something I have not been able to do since my hairloss”

“I can hardly wait for my new look! This is such an incredible relief”