DoctorsInsurance and Vitiligo

Insurance and Vitiligo

Narrow band phototherapy is fully covered in the United States by Medicare with no additional costs to the patient, plus a Medicare rebate applies to a percentage of the consultation cost.

Most of private health insurance companies initially reject claims for reimbursement. However, with enough efforts they will eventually provide patients with coverage for NB-UVB phototherapy for vitiligo.

Write a letter to the insurance company, explaining a medical necessity for an urgent intervention to arrest disease progression. It should also mention the risks of vitiligo, such as serious sunburn - if that's the case - and a heavy socio-ecomonic burden of the disease. Avoid mentioning emotional or cosmetic effects in claims.

Ask your patient to send a personal letter to the health insurance approval department. Emphasize the same aspects but from a more personal point of view. Follow up with phone calls and any supporting evidence, explaining the devastating effects of vitiligo on his or her life. Patients can also ask for free insurance reimbursement assistance on the purchase of home UVB units from manufacturers based in USA or Canada.

Sample Letter

"Mr./Mrs. <name> has been under my care since <date> and suffers from generalized vitiligo over <parts of the body>, which is now greater than <...%> of his/her body surface area. The patient has a history active vitiligo, which requires immediate treatment to limit further progression of the disease and prevent appearance of new lesions.

Topical and oral medications have been tried first, including <drug name> for <duration period> with no effect.

The patient has also been treated with ultraviolet lights type B (UVB) in our clinic and has shown significant improvement. As vitiligo is usually a life-long condition that requires scheduled follow-up with a low-dose maintenance therapy to minimize risk of relapse, my patient will most likely require UV light treatment for indefinite use. An FDA approved home-based UV light device would be effective for the patient’s condition.

The home UV light unit would be of lower cost than the same treatment at a clinic as vitiligo is a chronic condition generally requiring a minimum of 130 treatments over just the next 12 months. The results of home-based UV therapy are comparable to a clinic-based therapy with a lesser socio-economic burden to a patient. Each in-clinic visit will cost approximately <e.g. $85.00> yielding a minimum yearly treatment cost of more than <e.g. $11,000> whereas a one-time cost of a home UV unit is only <$...>.

Therefore, I am recommending <brand name, model> with Narrowband UVB lamps due to its ease of use, effectiveness and relative safety - derived from the device’s control of maximum exposure time coupled with its physician controlled timer where I can guide the patient’s use through periodic visits in my office. I feel my patient is capable of operating the home UV unit and staying within prescribed exposure times."

FAQOther Questions

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