Getting coverage for a ‘cold cap’ during chemo can be tricky

It’s not about vanity.

Being able to keep your hair during chemo means being able to keep your dignity, even your privacy.

That’s why I was so happy when I first told you about a technology called “cold cap therapy” five years ago. It’s a proven way to help those undergoing chemo keep a lot – sometimes all – of their hair.

And since I first gave you the details, the FDA has cleared one cap… and is in the process of giving clearance to another.

But unfortunately, many doctors still don’t know about it. And even when they do, getting insurance to cover the treatments can be like pulling teeth.

Despite that, there are still ways to not only receive the cold cap treatments, but to get insurance companies to cover the cost — if you know where to look and what to do.

Letting cooler heads prevail

Cold cap therapy for chemo patients isn’t a brand new idea. It’s been used for decades in Europe, but only last year did it start to make waves in the U.S.

Patients wear a tight-fitting cap that’s been chilled to cool the scalp down. How chilled depends on what kind you’re using. The FDA-cleared DigniCap stays above freezing (32 degrees ºF), but others that need to be manually chilled will start out much colder, well below zero. It’s worn before, during and a few hours after chemo sessions.

It protects the hair follicle cells by slowing their metabolic activity. One doctor describes it as putting “the hair follicle to sleep” so it’s not as sensitive to the effects of chemo drugs. The extreme cold also constricts blood vessels to the point that it can reduce the amount of cancer drugs that make it to the scalp.

And cold caps have been found to be amazingly effective in allowing people to keep their hair. The researchers involved in the clinical trials for DigniCap say that most women who use the treatment will only lose around 25 percent of their hair, with some keeping all of it.

Breast cancer patient Donna Tookes, for example, was able to retain her entire mane of silver locks despite 12 rounds of chemo. And many other patients are reporting the same success. Also, they say, even with some areas of thinning, those spots grow back much faster when cold cap treatments are used.

So the real question here isn’t whether it works, but how patients can get their hands — or should I say heads — on it?

And then there’s the cost. Now, you would think it would be a cinch to have your insurance cover it – especially since wigs are considered a covered medical expense on many plans.

Yeah, you would think.

But that’s not always the case. Many patients, however, have found a workaround that has to do with how their doctor fills out the insurance papers.

For example, if your insurance covers wigs, have your doctor use the same code as he would for that – which is technically called “cranial prosthesis.” Also, if your provider turns down coverage, many people have had that decision reversed by simply calling and asking for the reason payment was denied. Often, that has to do with an incorrect code being used.

If you’re thinking that every cancer clinic has these cold caps available, I’m sorry to tell you that’s not the case (I’ll give you a link at the end to find medical centers that use the treatment). But you can – with your doctor’s permission – arrange to bring in your own.

The main difference is the ease of use (and the temperature) with the FDA-cleared one, versus other brands.

While the DigniCap is chilled by a special control unit, if you BYOC, you need a cooler and dry ice to get it down to the proper temperature.

For a list of treatment centers that can provide the DigniCap or have special freezers available for other brands, visit www.rapunzelproject.org.

“Cold caps may prevent hair loss in breast cancer patients” HealthDay, December 12, 2016, newsmax.com

How to save your hair during chemo