Yesterday we received a denial of coverage for a wig from Pacificare, our health insurance company. Even when phrased as a "cranial prosthesis for chemotherapy hair loss," Pacificare wrote that a wig is not a covered benefit under our policy.
The interesting thing to me is whether this is something negotiated by the Seattle Public Schools
as part of their health insurance contract, or if Pacificare routinely does not cover wigs for hair loss due to chemo. Either way, it's clear to me that the people who do the contract negotiations have never been through chemo and experienced hair loss, or they would clamor to include wigs as a covered benefit. Does the Seattle School District really want their teachers, especially the female ones, going to school bald from chemotherapy? It seems to me looking at a bald female teacher would distract students from learning.
I decided not to sing with Dunava at the NW Folklife Festival later this month because 1) I wasn't sure how I would feel after a few rounds of chemo, but even more 2) if I go on stage bald, or wearing a scarf over a clearly bald head, it would distract the audience from our performance.
I can still purchase the $240 wig instead of the $1600 one for days when I want to look like I have hair.
So I have added to my chemo mantra that I will be part of the 10% of those taking abraxane who keep their hair. And that abraxane will be well-tolerated, with minimal side effects, and very effective.
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"cranial prosthesis for chemotherapy hair loss" is how my insurance worded it as well, though it is stated as a once-in-a-lifetime benefit...so I guess they are saying 'choose wisely', or living in denial that any of their clients will ever have cancer again. At least not before hair-styles change.
ReplyDeleteDouble check with Pacificare. Voice to Voice. We all know how screwed up things get. But double check on the repeatability of the benefit, if you had one before.
My health insurance does not cover wigs. Face it, when insurance rates are negotiated if they can cut things out, they do. Benefit plans change. I do get up to 75 physical therapy appointments a year. I definitely get my money's worth from them so I paid for my wig and was happy about it.
ReplyDeleteI did call Pacificare before trying the prescription/referral route, got the same answer over the phone as in writing. A wig is just not a covered benefit. My husband offered to contact the school district's benefits administrator to find out why.
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