Does Health Insurance Cover The Cost Of Your Medical Wig?
The short answer is yes. If you are experiencing hair loss whether temporary or permanent. Unfortunately, not many people know this. But needing a wig due to hair loss caused by alopecia, chemotherapy, or other medical conditions, is covered by many insurances. And you can file an insurance claim for the full or partial cost of your cranial prosthesis.
What is a Cranial Prosthesis?
A cranial prosthesis is a custom-made wig specifically designed for individuals who have lost their hair due to medical conditions or treatments, such as cancer (chemotherapy), alopecia, or severe burns. These prostheses are typically made from high-quality, natural-looking materials and are designed to fit comfortably on the scalp, mimicking natural hair growth.
It’s important to know the terminology when applying for medical insurance or tax deduction status. Other common terms used to describe a medical wig include: cranial hair prosthesis, hair prosthesis, and full cranial prosthesis. Please do not say wig.
Your Insurance Will Let You Know If You’re Covered
Whether or not your medical wig is covered by your insurance company depends on your plan. But it’s possible to receive full payment for your full cranial prosthesis. However, while some insurance companies will pay for your prosthesis upfront, others require you to pay upfront and then get reimbursed.
Many insurance companies cover 80-100% of the cost for your full cranial prosthesis. They also allow one cranial prosthesis per year for medical hair loss. Additionally, you may also be able to deduct your prosthesis as a medical expense on your taxes. However, it has been confirmed that if medical bills exceed 7.5% of an individual’s income,
Types of Hair Loss Covered By Insurance
- Hair Due to Chemotherapy
- Kidney Related Hair Loss
- Hair Loss Caused by Cancer
- Alopecia
- Radiation Related Hair Loss
- Hair Loss Due to Thyroid Problems
- Medical Hair Loss Due to Life and Environmental Changes, Thinning and/or Balding, Genetics, Stress, Aging, Reaction to Medical Illness
The Steps You Should Take
Contact the benefits department for your health insurance and ask:
- Does your policy cover a cranial prosthesis?
- If it does, what type of prosthesis is covered (I.e. human hair wigs, synthetic wigs, etc.)
- How much of the cost do they cover?
- How much for out of network?
- What specific terminology for a wig should the prescription contain?
- Is there required documentation they need to submit your claim? What is it?
Note: When reviewing your insurance policy and you don’t see cranial prosthesis listed, it doesn’t necessarily mean you don’t have coverage. We strongly recommend that you call your health insurance company and get pre-authorization.
NEXT:
- Get a prescription for a “cranial prosthesis” from your doctor. Make sure that’s the correct terminology required by your health insurance provider. Also, include procedure code A9282. It’s important that the prescription does not say “wig”. Because a wig is considered a fashion item, it is not medically necessary. The procedure code/number on your cranial prosthesis prescription is used to submit your insurance claim.
- Add a personal touch. By having your doctor write a letter, you become more human, and not just a claimant. In the letter, your doctor can explain hair loss and its devastating effects on a recipient. Also, he/she can state that your prosthesis is not for cosmetic reasons, but for your emotional well-being.