Hair Loss – Alopecia

HMSA plans do not cover the treatment of alopecia or baldness regardless of the patient’s condition. This exclusion includes, but is not limited to, visits for treatment of alopecia, hair transplants, topical medications and intralesional injections. These services and procedures are not covered benefits and should not be billed to HMSA.

Diagnostic Services

HMSA plans cover services related to the diagnosis of alopecia. Examples of diagnostic services that are covered include:

• Initial office visits for patients who seek medical advice regarding unexplained hair loss.
• Laboratory tests, when the physician is not able to make a conclusive diagnosis and orders laboratory tests to help determine the reason for the hair loss. The date of service for the lab testing must fall between the first and third diagnostic visits.
• A second and third visit, if needed, to discuss the findings of any lab work as well as the physician’s diagnosis and recommendations for treatment.

Visits subsequent to the diagnostic visit(s) are not a covered benefit.

Revision History