If you suffer from hyperhidrosis, or have a loved one who struggles with the condition, you know that excessive sweating is serious - and that it significantly impacts quality of life and functioning. As an impactful medical condition with substantial negative effects on physical, emotional, and social well-being (as well as academic and occupational life), hyperhidrosis deserves to be treated seriously by health insurance organizations and other third-party payers.
To help, the International Hyperhidrosis Society provides useful tools, information and downloadable forms related to the insurance and reimbursement process. These resources can help you work with your physician, health insurance plan, and even your employer to get the coverage you deserve for the treatments you need.
To start, if you and your healthcare provider are looking for diagnosis codes, here are the latest:
L74.5 - Focal Hyperhidrosis (L74.5 and L74.51 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail)
L74.51 - Primary Focal Hyperhidrosis
L74.510 - Primary Focal Hyperhidrosis, Axilla
L74.511 - Primary Focal Hyperhidrosis, Face
L74.512 – Primary Focal Hyperhidrosis, Palms
L74.513 – Primary Focal Hyperhidrosis, Soles
L74.519 – Primary Focal Hyperhidrosis, Unspecified
L74.52 - Secondary Focal Hyperhidrosis
L74.8 - Other Eccrine Sweat Disorders
L74.9 - Eccrine Sweat Disorder, Unspecified
R61 - Generalized Hyperhidrosis
Have you been denied coverage for your hyperhidrosis treatments? You do have recourse. Follow the step-by-step guide below to appeal your health plan’s decision:
- Find out if your health plan covers hyperhidrosis treatments
Your insurance company may already cover hyperhidrosis treatments. Use our list of links to U.S. public hyperhidrosis coverage policies and other third-party payers to find out. If we don’t have yours listed, call your health insurance organization to find out what it is (then please send us the link, if there is one, so we can post it.)
- Calculate the cost of hyperhidrosis
This list can help you calculate how much money you spend managing excessive sweating – along with other costs. Use your answers to the questions provided and the key Hh facts to help convince your insurance plan that you deserve reimbursement for treatments. Or, if you have to pay for treatments out-of-pocket, the info on this page may help you to see that the investment makes economic, as well as emotional, sense.
- Download a Letter of Medical Necessity
Add evidence to your case, download this Letter of Medical Necessity and have your doctor submit it to your insurance company as proof that your hyperhidrosis needs treatment. Feel free to add to it or modify it.
- Download Hyperhidrosis Preauthorization Request Form
Similar to the Letter of Medical Necessity, this form should be completed by your physician and submitted to your insurance company. It demonstrates that you’ve been diagnosed with hyperhidrosis, lists the treatments that you’ve tried (and that have been unsuccessful), and states the treatment that your physician is recommending next.
- Download Medical Insurance Statement Form for the purchase of a home-use iontophoresis device
Looking to purchase an iontophoresis device to treat hyperhidrosis of your hands and/or feet? You may be able to receive reimbursement for your home-use iontophoresis device. Download useful forms and learn more about iontophoresis and insurance coverage.
- Get help with Botox reimbursement or savings
If you are seeking reimbursement for treatment with Botox, you may find help through Allergan's Botox Patient Assistance Program (for the uninsured or underinsured) or BOTOX ONE. Both programs will require the involvement of your physician, so be sure to ask him or her about them.
- Consider participating in research trials. While not technically insurance-related... research or “clinical” trials are another potential avenue for anyone seeking treatment for hyperhidrosis. Clinical trials help to further medical science's understanding of a condition and its therapy. To learn more about clinical trials, how they can make treatment more affordable (even free), and whether you may be eligible to participate in a hyperhidrosis trial, visit our research opportunities page.
- Subscribe to our free News Blog. Often during our medical education sessions, we allow patients to receive free treatment. We always announce these opportunities first to our subscribers.