Medical Wigs: Health Insurance Reimbursement Tips
We understand that dealing with medical hair loss can be challenging enough without the added stress of figuring out how to finance a high-quality wig that matches your natural hair texture. This section is for customers who are purchasing a wig for medical purposes. Can insurance help purchase a wig? 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.
At Coils to Locs, we’re committed to making this experience as positive and barrier-free as possible. Although we can’t guarantee that every insurance company will cover the cost of your coily, curly, highly textured wig, we’re confident that the following tips will help you navigate the process.
Can Health Insurance Cover the Costs of your Medical Wig?
If you're going through temporary or permanent hair loss due to illness or genetics, we want you to know that there's hope! Not many people are aware, but if you've lost your hair due to medical reasons like chemotherapy, alopecia, trichotillomania or other conditions, you can actually file an insurance claim to help cover the cost of your cranial prosthesis if your health plan provides coverage due to medical hair loss.
What is Cranial Prosthesis?
First, it’s important to know that a cranial prosthesis is simply a medical term for a wig. It’s commonly used to treat hair loss due to chemotherapy, radiation, alopecia and other medical conditions.
The term, cranial prosthesis, is used when applying for medical insurance or tax deduction status. Other common terms for a wig used for medical purposes include: full cranial prosthesis, hair prosthesis, cranial hair prosthesis, extra-cranial prosthesis. When applying for insurance coverage, be sure to use the term “cranial prosthesis” or the preferred terminology required by your health insurance, rather than simply “wig”. Your insurance provider may have specific requirements for the type of cranial prosthesis that’s eligible for coverage, so it's important to clarify this in advance.
Your Coverage Depends on Your Insurance Plan
To get started, find out if your policy covers the cost of a cranial prosthesis and how much of the cost is covered. Your medical provider can help you request a prescription for a cranial prosthesis, including the diagnosis code and procedure code. It’s also a good idea to ask for a letter clarifying that your selected cranial prosthesis is medically necessary for your emotional well being, rather than simply cosmetic. Most insurance companies will cover between 80-100% of the cost for your cranial prosthesis. However, individuals should discuss this with their provider and health insurance company since through research, we discovered that in default policies there's no coverage for wigs as they are part of the Standard List of Exclusions.
Most Types of Medical Hair Loss Covered by Insurance
- Alopecia Hair Loss
- Chemotherapy Related Hair Loss
- Radiation Related Hair Loss
- Thyroid Related Hair Loss
- Kidney Related Hair Loss
- Cancer Related Hair Loss
- Medical Hair Loss Due to Genetics, Stress, Reaction to Medical Illness, Life and Environmental Changes, Aging, Thinning and/or Balding.
Find Out If Your Cranial Prothesis is Covered By Insurance
- Find out if your policy covers the cost of a cranial prosthesis and how much of the cost is covered.
- If yes, ask which specific kinds of cranial prosthesis are eligible (synthetic wigs, human hair wigs, etc.) and be sure to clarify the preferred terminology for your prescription. Example: Cranial prosthesis versus hair prosthesis.
- Ask what specific type of paperwork will you need to process your claim?
- Request a prescription for a “cranial prosthesis” or the preferred terminology required by your health insurance, (do not use the word “wig”) from your medical provider. You will very likely need to include the diagnosis code and the procedure code.
- Consider asking your medical provider to include a letter clarifying that your selected cranial prosthesis is not for cosmetic purposes but rather, “medically necessary” for your emotional well-being.
- Keep copies of all your documentation. This purchase may qualify for a tax exemption, or you may need it for a future appeal.
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.
At Coils to Locs, we are unapologetic in our efforts to help you remain your authentic self. Our collection of coily, curly, highly textured wigs for medical hair loss are here to do just that, keep you looking like you!