Alopecia World
www.alopeciaworld.com
ANY & ALL HELP ACCEPTED, IT'S ADMINISTRATIVE LAW JUDGE PRESENTATION TIME
Monday, August 10th I go before Medicare's Administrative Law Judge, the hearing I requested was for a cranial prosthesis/wig coverage. The initial request for a wig/cranial prosthesis from my Dermatologist in January was denied.
Medicare, (shame on them & their neanderthal attitudes regarding cranial prosthesis) I am so frustrated, with them, according to one denial letter, in order for a wig to be covered it must,
stand up to repeated use,
mainly be used to serve a medical purpose
useful to a person who is not ill or injured
be appropriate & needed for us in the home and
be reasonable & necessary to treat an illness or condition.
Oh another excuse, was "wigs or as you called them a cranial prosthesis (yes Medicare said that) are not covered because anyone who is well or uninjured can walk into a saloon & pick one up". Oh! They are so ignorant.
Please if anyone has suggestions or information for me please send it my way, any & all 411 will be appreciated.
I know my changes are slim to none but if we don't start speaking up & out coverage will never take place.
I am also contacting my local congressmen as well as Senators Boxer & Feinstein (spelling) I'll take help from big guns.
I contacted the NAAF & they sent me out some material.
Again if anyone has experience in going before an Insurance & or Medicare Administrative Law Judge or presentation ideas I am wide open.
I will try my best to be a brave lil buck-a-roo, I am scared but I even madder & think that will really help me in getting over my fear.
Wish me luck & of course any & all prayers are very welcome.
Pam
Medicare, (shame on them & their neanderthal attitudes regarding cranial prosthesis) I am so frustrated, with them, according to one denial letter, in order for a wig to be covered it must,
stand up to repeated use,
mainly be used to serve a medical purpose
useful to a person who is not ill or injured
be appropriate & needed for us in the home and
be reasonable & necessary to treat an illness or condition.
Oh another excuse, was "wigs or as you called them a cranial prosthesis (yes Medicare said that) are not covered because anyone who is well or uninjured can walk into a saloon & pick one up". Oh! They are so ignorant.
Please if anyone has suggestions or information for me please send it my way, any & all 411 will be appreciated.
I know my changes are slim to none but if we don't start speaking up & out coverage will never take place.
I am also contacting my local congressmen as well as Senators Boxer & Feinstein (spelling) I'll take help from big guns.
I contacted the NAAF & they sent me out some material.
Again if anyone has experience in going before an Insurance & or Medicare Administrative Law Judge or presentation ideas I am wide open.
I will try my best to be a brave lil buck-a-roo, I am scared but I even madder & think that will really help me in getting over my fear.
Wish me luck & of course any & all prayers are very welcome.
Pam
-
Comment by Becca on August 3, 2009 at 10:10pm
-
Hi,
I am in the same place that you are. I was thinking what I could do to try to get wigs/cranial prosthesis covered for people that have alopecia. I don't understand insurance. I know Medicare will cover a wig for cancer. I don't understand why insurance does not cover a wig for alopecia. I had a wig from locks of love. That stood up to the test of time. It's now 13 years old and it's time to get another one... Anyway I called both of my insurances today and they don't cover cranial prosthesis. Have you tried submitting medical notes. a cranial prosthesis is exactly that a prosthesis. Insurance company's cover limb prosthesis so why not a cranial prosthesis. I am with you. I will write to my congressman too.
-
Comment by Lee on August 3, 2009 at 10:41pm
-
I need to do the same thing...my insurance company only covers $500, and my wigs have cost me $8000 almost in the last year! I'm in serious debt now. Is tough to fight though...let me know what happens! Do you have a lawyer?
-
-
By the way...I have done everything except get a lawyer...EVERYTHING...and Im at the point where Im about to give up.
-
Comment by Mary on August 3, 2009 at 11:08pm
-
Good luck, Pam. Let us know how it goes.
-
Comment by Pamela Rosse on August 3, 2009 at 11:49pm
-
Hi Becca, I just left you a message on your site. First, again, do you have proof that Medicare pays for wigs/cranial prosthesis for cancer patients? If so the proverbial foot is in the door. Because if they cover cancer patients, whose hair comes back & do not cover patients with Alopecia who's hair does not come back, that, that I consider to be a form of DISCRIMINATION. That I will look into getting an attorney for. That I think would make for a very interesting story for the news I would hope. Give Dateline or 2020 a call.
I have submitted all of that, its the reason I go before an Administrative Law Judge, I have taken it about as far as I can. Thanks keep writing your congressman & Senators, it's how we get things changed.
Pam
-
-
Pam,
OK soooo sorry. I have this backwards. (I work for an insurance company, TRICARE, it's for those that served in the armed forces) TRICARE covers a wig for cancer patients not Medicare.
-
Comment by panuelo girl on August 5, 2009 at 5:15pm
-
Please keep us posted this is an important issue and we'd love to know the outcome. Good luck to you!
-
-
Hey Panuelo girl, I will let you know the outcome. I might be facing a brick wall with neanderthal attitudes but as they say that squeaky wheel gets the job done, we all need to be squeaky wheels, calling our Congressmen & Senator's, I have placed two calls to both Ca Senator's, Boxer & Feinstein. Will see how much assistance I get. Will keep you informed. Thanks for the support it is most appreciated.
Comment
© 2024 Created by Alopecia World.
Powered by
You need to be a member of Alopecia World to add comments!
Join Alopecia World