Question about medical insurance and what constitutes a prosthesis?

There is a disease called alopecia areata. It causes hair loss, and usually strikes women. It usually happens to women in their late teens, early 20's.

There are two main forms of the disease. Alopecia areata totalis, and alopecia areata universalis.

With alopecia areata totalis, the patient looses all the hair on their head (sometimes eyelashes and eyebrows as well). With alopecia areata universalis the patient looses all the hair on their entire body.

This is the definition of a prosthesis in the dictionary:
"an artificial device to replace or augment a missing or impaired part of the body"

Insurance companies are required to cover breast implants for breast cancer patients (even the side that didn't have cancer), because the female breast is viewed as such a part of being female, and helps breast cancer patients recover emotionally and psychologically.

So my question is, do you think that wigs for women with alopecia areata should qualify as a prosthesis under the insurance companies?

2010-04-08T21:51:52Z

Alopecia affects about 75% female patients, and 25% male patients.

The disease does affect far more women than men. I'm also only speaking about women patients. Baldness is accepted, even found to be sexy in men, even very young men.

So one person so far thinks a young woman can funcution normally in society, being bald, without a wig for a prosthesis.

2010-04-09T08:40:57Z

I'm finding it interesting that people don't think a wig should be covered as a prosthesis for women.

I worked for a Dermatologist for almost nine years, and we saw a lot of patients with alopecia. The men, after the initial shock, adjusted well mentally. Not a single one of the women patients ever adjusted well.

Every one of them was impacted in their social and working life. I remember one who was a public school teacher (in Seattle) who was tormented by her students (substitute teacher). She had to buy her own wig.

A beautiful young lady who had long blonde hair. She couldn't afford her own wig, and eventually quit her job as a bank teller because of all the rude comments by customers. She had been bright, out-going, and funny. She became a completely withdrawn and negative person (despite medication).

I saw the mental side effects in the women over and over again, and it REALLY impacted their lives.

A quality wig is about $2000 and more.

2010-04-09T08:45:50Z

The insurance companies will not cover the wigs. They will however cover visits to Dermatologist, visits to therapists, and physchologists, anti depression medications, and all sorts of monthly expences incured with alopecia. Over a years time, the expences a patient racks up with the other costs far exceed the cost of a wig.

That teacher who purchased her own wig didn't come in for a year. I though she'd moved. Nope, she just felt so much better about herself, and was able to function normally in public she stopped comming in for the alopecia.

Anonymous2010-04-08T22:02:04Z

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Probably not - if you mean by comparison to other things that are or are not covered. For example, suppose that you are in a car accident and your face is severely disfigured. Most insurance programs will not cover reconstruction unless that reconstruction is needed to address "function" (eyesight, ears/nose/mouth function, etc.). By the way, how much does a wig cost?

And, lastly, if you are asking if a bald woman is still sexy - the answer is yes.

Colonel Reb2010-04-08T22:12:13Z

Actually there are a lot of people who will judge men quite differently (by that, I mean worse) if they're bald. It's not nearly the socially debilitating issue for men it is women but it is still a negative thing to many people, depending on the man. Some men can pull it off, others can't.

I would hate to go bald as a man, so why couldn't I get a wig too under your idea if it would help me out psychologically? Why do we focus so much only on women in cases like this?

I'm not sure where you're getting your stats as I saw nothing backing them up when I looked, in fact most sites talked about how men usually got the worst form of the disease, alopecia universalis, which causes total baldness (I was actually looking for other information but noticed that while I was doing so).

Anyway, on to your question, I'm not really sure this is something the insurance companies should pay for. Unless it can be proven the hair has a direct correlation to a person's health or livelihood, hair really isn't a necessary part of life. I wouldn't have a problem with insurance companies paying for it as going bald can have a huge psychological effect on someone, particularly women, but it's not something I think should necessarily be covered such as a prosthetic leg or even breast implants due to breast cancer.

Apparently you're just looking for answers which say "yes" and go on. You want a double standard, and that's that.

Anonymous2010-04-08T21:43:52Z

Alopecia is common in both sexes. On the other hand, male pattern baldness is more common and affects a significant portion of male population.

Hair implant is prosthetic only if the profession demands it. otherwise it shouldn't be covered. Although in cancer survivors, during the chemotherapy, many insurance plans cover the wigs.

It is not, in my opinion, a prosthetic.

corina2017-02-09T13:07:19Z

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John2017-01-27T21:39:57Z

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