Insurance claims for vitiligo

insurance claim

The medication and treatments necessary to a vitiligo patient are long term and costly. Depending on the insurance company you are with, they may cover the price of medication, home treatment unit, doctor appointment fees, UV sessions in the doctor’s office or none of the above. The most helpful type of reimbursement is the reimbursement for the UV unit - a hand-held UVB unit may suffice for a patient with few affected areas but if your spots are widespread a panel type unit is necessary, with prices starting around 1000$.

Sometimes the insurance company covers part of the price of a UV unit or requires a letter of medical necessity from your doctor to back up your claim. You can suggest your doctor to mention some of the below points in the letter in order to improve the chance of success of your claim:

•    Emphasize on the benefit for the insurance company on the long run – compare the price for the estimated number of treatments in the doctor’s office costing X $ versus a one time payment for the home unit – costing less;
•    Mention that other therapies have been applied but with little result. For example mention that the patient is non responsive to topical therapy
•    Necessity of the device in order to regain pigment and keep the disease from spreading and to avoid severe sunburn – a known cause of skin cancer

Avoid mentioning emotional or cosmetic effects in claims. Frequent reasons from insurance companies for the denial of claims are that vitiligo is a ‘cosmetic disorder’ or that other treatments should be sought before the cream/equipment/procedure mentioned in your claim.
Denied claims can be appealed but during this time consuming process, your spots could further spread instead of being arrested by a swift treatment.

Other reasons for insurance companies to deny useful vitiligo medication such as Protopic or Elidel is the lack of FDA approval for vitiligo treatments – these two only being licensed for eczema.

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