Wigs & Insurance

Medical Wigs: Your Insurance Coverage Guide

Welcome to the Wig Expert Medical Wig Insurance Coverage Guide! This section is for clients who are purchasing a wig for medical purposes. Can insurance help purchase a wig? The answer is yes, but it takes a bit of work to find out if you’re qualified, and if your health insurance policy is among the many that offer this option. Below, explore our comprehensive guide to medical wig insurance claims. 

Can Health Insurance Cover the Cost of Your Medical Wig?

Are you experiencing temporary or permanent hair loss from illness or genetics? Very few people know this, but when you lose your hair due to medical reasons such as chemotherapy, alopecia, trichotillomania, or other medical conditions, you can file an insurance claim to receive a partial or full cost of your cranial prosthesis.

Steps to Follow - The Process - Steps You Should Take 

Contact your Health Insurance Provider's Benefits Services and ask:

  • If your policy covers a cranial prosthesis
  • If yes, what type of cranial prosthesis is covered (i.e. synthetic wigs, human hair wigs, etc.)
  • How much of the cost will they cover
  • What specific terminology they need to have on the prescription for a wig
  • What specific documentation they need to submit your claim.

Note: If you are reviewing your insurance policy and do not see cranial prosthesis listed, this does not automatically mean that you don’t have coverage. We highly recommend calling your Health Insurance Provider and getting pre-authorization.

Next:

  • Request and obtain a prescription for a “cranial prosthesis” (or the specific terminology required by you Health Insurance Provider) from your doctor or physician including the medical procedure code A9282. Make sure the prescription does not say “wig.” A wig is a fashion item and is therefore not medically necessary. Your prescription will include a procedure number/code for your cranial prosthesis that will be used to submit your insurance claim. 
  • Add an extra touch: Ask your physician to also write a letter explaining hair loss and its effects and have her/him state that it is not simply for cosmetic reasons but for emotional well being.
  • If you are planning on paying upfront or out of pocket initially, place your order online at thehairmama.com.
  • Once you place your order with The Hair Mama, email info@thehairmama.com with your order number and say that you need a copy of your invoice for your cranial prosthesis prescription.
  • We will provide you with a copy of your invoice with a notation on the bottom that states Cranial Prosthesis and The Hair Mama Tax ID number (85-2092623).
  • Send all documentation (your doctor’s prescription, copy of your invoice from The Hair Mama, completed insurance claim form, and any other necessary forms) to your Health Insurance Provider.

 

Insurance Companies and Their Cranial Prosthesis Coverage

  • Blue Cross Blue Shield does not cover wigs as a cranial prosthesis for group and individual insurance plans.
  • Aetna's group medical insurance plan does not cover wigs as a cranial prosthetic. However, individuals should verify with Aetna that the individual plan they are on will cover this item or not. 
  • United Healthcare does not cover cranial prosthesis under group medical insurance plans. However, individuals should verify with United Healthcare that the individual plan they are on will cover this item or not. 
  • Medicare will not pay for a cranial prosthetic wig even if the claim is filed under durable medical equipment. This means that anyone over 65 years old that has a medicare advantage plan or a medicare supplement plan, these plans will not pay for a wig. This has been confirmed by a Medicare Representative.
  • Ambetter does cover cranial prosthetic wigs under individual policy plans. Check with your insurance representative to see if your plan includes cranial prosthesis coverage.
  • Humana does not cover cranial prosthesis under their group insurance plans.  
  • Baylor Scott & White does not cover wigs as a cranial prosthesis.
  • Oscar does cover cranial prosthetic wigs under individual policy plans and group medical plans. Check with your insurance representative to see if your plan includes cranial prosthesis coverage.
  • Molina does not cover cranial prosthetic wigs under individual policy plans.
  • Cigna - awaiting verification
  • National General - awaiting verification
  • Fidelis 
  • General Electric
  • ChampVa 
  • TriCare
  •  

    For any additional questions, please reach out to Vicky Brown at victorialbrown33@yahoo.com