Hair prosthesis denied by insurance

I am not trying to hurt your feelings, but that is one very expensive hairpiece. Mine, paid for by a medicaid voucher, cost somewhere about $50. It satisfies me, and does not drive me deeper in debt.

Hi Maria. Even when insurance covers scalp prostheses, there is a limit. My insurance only provided $350. That wig shop ripped you off, and they should be ashamed of taking advantage of someone with cancer. You could have purchased several synthetic wigs for what they charged you. If you haven't worn it yet, I'd try to return it.

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Hi Maria,

Yes, human hair wigs can be very good quality, but very expensive as you’ve discovered. I would venture a guess that most chemo patients do not buy wigs at the price point you paid. Human hair wigs require more care than synthetics too. As others have mentioned, even when insurance does cover wigs, the limit is usually less than $500. Synthetic wigs have come a long way and you can easily find a couple for far, far less than a human hair wig.

I had my wig* fitted at a shop specializing in all things breast cancer and they did not recommend human hair, unless money was no object. If you haven’t worn your wig yet, please try to return it and rake them over the coals for ripping off a cancer patient!

* I ended up not having chemo, so never actually used it

I'm so sorry you are going through this. I also purchased a human hair wig and it was $1600.00. I called my insurance company from the place of purchase to confirm it was covered as I had to lay out the money first and then submit to my insurance and they said it would be covered. After I purchased it and had it cut and styled similar to my real hair I was just browsing through my covered benefits on line and clicked on the cranial prosthesis coverage and it said specifically only covers synthetic wigs. I freaked out as last thing I needed was not to get reimbursed for this wig. I said ok just submit the claim and see what happens. I too was on a recorded line when they told me it was covered so I knew I had that in my favor if needed. They sent me the check in full a few weeks later without even questioning it. I was so relieved and especially since I never even wore the wig. Not once. I wore the same one baseball cap for 8 months until my hair started growing back. I wish I would've waited to buy the wig and even all the chemo scarves and hats I bought. I wish I could help you and point you in the right direction. Maybe a lawyer? I think if they told it you it was covered on the phone and it's rcorded line and you bought it then and there and it's not refundable they need to cover it regardless. You did your due diligence.

The problem with a rep telling you that recorded or not is that they can say and have said the reps were wrong which apparently they were. Not a good thing and not the proverbial written word unfit unfortunately. They can't dispute what's in print. I learned that the hard way. We didn't know the facility had to be in network too so we were billed for OON. I challenged it and never heard another word.

We rely on the medical staff to verify insurance and coverages which they do so that shouldn't have happened but it was our fault because we didn't do our homework. It would have meant a $3k payment. A lady in the doctors office told me to always keep protesting the charge because eventually the squeaky wheel gets the grease.

We appealed anotherinsurance decision that would have meant we had to pay $5k out of pocket. I knew we had done our due diligence and it was the doctor who fumbled the ball. I talked to the BC rep(our insurance carrier) and she suggested we appeal it. I did and we won the appeal so sometimes you do win. Our case was different from yours and we didn't have to rely on a rep mistakenly steering us in the wrong direction.

That really stinks. That's a lot of money. Are there any other options in the appeal process?

Diane

Tell your insurance company that you are going to file a complaint with the State Insurance Commissioner. Then, call the State Insurance Commissioner’s office and find out how to file a complaint. Then if needed, file that complaint.

so sorry about that, maria. I know you have a lot on your plate now, but if you have time, you should let the shop where you purchased the wig know how they ripped you off. No one should have to borrow money to purchase a wig for chemo induced hair loss and no responsible, compassionate business should steer a cancer patient toward a wig costing over $2,000. dollars.

I don't think she was ripped off when I look on line wigs can cost up to $5000. I would keep after the insurance company they should pay something.

Meow,

I wasn't saying that the wig itselfwasn't worth it, as human hair wigs are expensive. But most cancer patients, for whom hair loss is temporary, opt for the considerably less expensive, easier to care for synthetic wigs. Synthetics have come a long way and are beautiful at a fraction of the cost. To put a cancer patient in the position to have to borrow money to purchase a human hair wig? The wig shop told her that she needed a good quality, human hair wig. I’d say that was a rip off!

Hi Maria, I'm sorry your insurance is causing so much stress. I've had a similar situations with mine, and it can be a real nightmare. My insurance wouldn't cover a wig either.

If you can't return the wig, I recommend just wearing it and loving it. Human hair wigs often do cost thousands. Fortunately the hair fibers are more durable than synthetic wig fibers. Basically, a human hair wig can last well over a year, whereas synthetic wigs will often frizz out and look wiggy in a few months. Of course, this varies depending on how much you wear it, and how long it is, etc.

I also had long, beautiful hair before chemo. I bought synthetic wigs with my own money, and since they had to be replaced more often, I ended up spending what you spent anyway.

Also, even after chemo is over, hair grows very slowly. I wore my wigs for months even though I had some hair regrowth. I personally just didn't like having super short hair, and I felt more like myself in my wigs.

Anyway, I'm rambling now, but I hope you can embrace and love your human hair wig. Also, if you're interested, you can check out Cysterwigs or Taz's Wig Closet on YouTube. Those channels are a wealth of information. Best wishes to you.