Insurance
Our guide to insurance coverage
In Various Cases, Insurance Covers the Expense of Hair Replacement Systems
If you’re considering our services due to a medical condition, your insurance may help cover the cost of a hair replacement system. Review your insurance plan or benefit booklet—specifically the “Covered Expenses” section—under terms such as “prosthesis” or “prosthetic devices.” These categories often include cranial prostheses, which may qualify for full or partial reimbursement.
Tips for Navigating the Insurance Process
To increase your opportunity for coverage, follow these important steps:
1. Obtain a Prescription
Request a written prescription from your doctor on a prescription pad, including the appropriate diagnosis code(s) (ICD codes). This is essential for insurance claims.
2. Request a letter from your doctor
Ask your physician to provide a detailed letter explaining:
o The extent of your hair loss
o Its emotional/psychological impact
The letter should clearly include medical terms like “cranial prosthesis” or “full coverage prosthesis.”
3. Photo Documentation
Include photographs of your current hair loss to document the need for medical—not cosmetic—support.
4. Request the Correct Invoice from Us
We will gladly issue an invoice or receipt stating “Full Cranial Prosthesis” to match your insurance’s terminology.
5. Write a Personal Statement
Share the emotional toll that hair loss has taken on your life. Stress that your prosthesis is medically necessary, just like a prosthetic limb or breast.
6. Include Employer Support (Optional)
If appropriate, have your employer write a letter explaining how your appearance affects your confidence and professional performance.
7. Keep Copies
Maintain duplicates of all prescriptions, letters, invoices, and claim submissions for your records or tax purposes. We can help you organize this documentation.
8. Contact Us for Assistance
If you purchase your cranial prosthesis through the World Hair Institute, contact us to ensure all insurance documentation is accurate and complete.
Insurance Providers That May Cover Cranial Prostheses
Coverage depends on your individual plan, but these providers have been known to cover up to 100%:
- John Hancock Insurance Company
- Metropolitan Life (up to 80%)
- Blue Cross Blue Shield (80%–100%)
- Metropolitan Educator of New York (80%–100%)
- Prudential Life Insurance (80%–100%)
- C.I.G.N.A. / Emerald Health Network (up to 100%)
- Med Choice Provident Mutual (80%)
- Equitable Life / Aetna (80%)
- Midwest Benefits Corp
If Your Claim Is Denied, You Still Have Options
1. Request a Written Denial Explanation
Ask your insurance company to specify why your claim was denied. Sometimes, it’s due to missing or unclear documentation.
2. File an Appeal
If you believe your claim was wrongly denied, write a formal letter to the insurance claims department and request a review by the medical review board.
3. File a Complaint (Illinois Residents)
If all else fails, file a complaint with the Illinois Department of Insurance.
Click here to download and submit the complaint form.
4. Save All Documentation
Keep copies of all communications, medical records, and receipts.
Even if insurance doesn’t pay, you may be able to deduct costs as a medical expense on your taxes.
No Insurance? You May Qualify for Financial Assistance
If you’re uninsured, you may be eligible for grants or vouchers through:
- State or county social service agencies
- County Departments of Social Services, which often offer medical aid for individuals meeting certain income requirements
We’re here to guide and support you through every step of this process.