The spotlight this week is on health insurance coverage for hyperhidrosis.  I know, YAWN.  Please keep reading, though– I have a few points to make that could help with your treatment!

If you have….by any chance… read my report on ETS (on your right, over there → ), you may know that you really MUST be proactive in dealing with your coverage.

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Herewith, a few facts and tips:

• In case you haven’t noticed (sarcasm alert), hyperhidrosis does not seem to get much attention in society at large, and also is the red-headed stepchild in the medical community as well.  This tends to result in health insurance policies either giving extremely narrow coverage parameters, or ignoring the disorder altogether.
• You really need to know what your policy does or does not cover.  Absolutely do not, DO NOT, call your insurance company and ask if something is covered.  Read the damn thing yourself.  This was a mistake that I made that very nearly cost my family $20,000.  It didn’t cost me in cash in the end, but the distress it caused was very real and completely unnecessary.  Hypothetically:  You call your insurance company and ask, “Am I covered for Botox treatments for hyperhidrosis?”  The person on the other end (who gets paid whether or not the answer you get is accurate or not) may respond, “Well, is it medically necessary?”  To which you reply, “Yes, absolutely, I think so!” That person then replies, “Well, then you’re covered!”  Then, you merrily go on your way and get the treatment.   Weeks or months later, a letter comes in the mail from your beloved insurance company informing you that you did not take the proper steps to prove medical necessity and therefore coverage for the treatment is rescinded.  And you are left with the bill.  Really.  That happened to me, but the treatment was not Botox.  It was about 20× more expensive.
• Oftentimes, the aforementioned “proper steps to prove medical necessity” for anything invasive and/or expensive require you to do any number of things, such as taking oral medication, using a prescription topical treatment, iontophoresis, etc.  Skip any of these steps at your own expense.
• Many policies I have reviewed will only pay for treatment of hyperhidrosis if hyperhidrosis is directly causing skin infections or diseases.  This means that you are only eligible for relief from sweating if the sweating is causing you bodily harm.  Because we are apparently not suffering enough. (sorry, insurance makes me snarky)
• If your insurance company balks at covering your treatments, a letter of medical necessity from your doctor may change their stance.
• If your insurance company refuses to cover your treatments or if you feel you are being treated unfairly, do not hesitate to contact the insurance commission for your state.  This is one of the things that I did, and I think it really helped my case.
• Keep a written record of all communication between you and the insurance company: dates, names, brief outlines of conversations.  Also print out any emails and keep any letters.  Again, that probably factored in my little victory.
• If it is worth the expense, don’t be afraid to get a lawyer involved.  Once again, I did!
• For more information and to download letters of medical necessity and other helpful forms, go to http://www.SweatHelp.org, which is the website for the International Hyperhidrosis Society.  See “Insurance Tools”– they have it all covered (pun intended )!

Please keep in mind that it costs insurance companies NOTHING to rescind payment or promise of payment for a procedure/treatment you have already received!  My lawyer told me that the vast majority of people who are denied coverage just accept the decision.  Don’t be one of them.

You have a medical disorder:  Your Sympathetic Nervous System does not work properly.  You do need medical intervention to correct it.  You pay for medical insurance; therefore, you have the right to coverage for the medical interventions your hyperhidrosis requires.   It is wrong that you should have to fight for that.  But you may have to–  and I hope you will.

If we don’t fight for what we are entitled to, how will anything change?  Do you want to fight insurance companies for the next 20 years?  I don’t.