How to Submit Your Wig as a Medical Prothesis for Insurance

Wigs covered by insurance are known as medical wigs or cranial prosthesis wigs. Many health insurance policies offer this option, but you will need to do some research to determine if you qualify.

Understanding Medical Wigs and Insurance Coverage

Unfortunately, many people experience permanent or temporary hair loss. However, not everyone knows that if you lose your hair due to medical conditions, you can file an insurance claim for a wig. These conditions include alopecia, trichotillomania, chemotherapy, or other medical issues.

CE Certified Wigs

Having CE Certification does not guarantee your TressAllure Wig will automatically qualify for insurance reimbursement. But our aim in seeking CE Certification is to make the process easier for you. CE Certification involves rigorous testing and quality control. It indicates the wig meets EU safety, health, and environmental protection standards, which enhances trust among healthcare providers. Being classified as a medical prosthesis means the product has been evaluated and approved for its use in medical contexts, underscoring its quality and reliability.

What Is a Cranial Prosthesis?

A cranial prosthesis is a medical wig made specifically for patients experiencing hair loss due to medical reasons. When applying for a tax deduction or medical insurance, you must use the term “cranial prosthesis.” Other acceptable terms for medical purposes include hair prosthesis, cranial hair prosthesis, and full cranial prosthesis. If your wigs are covered by insurance, the company may use a different name for this item. You can find out by reviewing your insurance handbook or contacting your insurance company.

How to Get Medical Wigs Covered by Insurance

As mentioned, you will need to do some work to determine if you qualify and if your insurance covers the cost of medical wigs. Here’s the process to get your cranial prosthesis wig covered:

  1. Get a Prescription and Referral: Obtain a prescription and referral for a medical wig from your doctor. The referral should use codes S8095 and A9282. Most insurance policies cover “prescribed cranial prosthesis” but do not cover standard wigs. You will need a letter or prescription from your doctor stating that the procedure is for a “prescribed cranial prosthesis.”
  2. Submit Documents to Your Insurance Company: Provide these documents to your insurance company.
  3. Insurance Company Contact: Your insurance company will contact your wig salon or wig retailer and they will provide an invoice to them listing the product as  full cranial prosthesis.
  4. For medical hair loss, you can receive payment for a partial or full cranial prosthesis. However, coverage depends on your insurance plan. if your insurance company does cover full or partial cranial prosthesis, generally, most insurance companies cover 80-100% of the cost of a medical wig, and you are typically entitled to one hair prosthesis per year for medical hair loss. Verify your coverage with your insurance provider first.

Tax Deductibility of Hair Prostheses

You may also claim your hair prosthesis as a tax-deductible medical expense. To find out if you can, contact your insurance agent. Generally, if your medical bills exceed 7.5% of your income, your wig is tax-deductible. Discuss this with your accountant or tax preparer for confirmation.

Dealing with Insurance Exclusions

Many insurance policies exclude wig coverage as part of their standard list of exclusions. In this case, contact your insurance agent or human resources department to amend your insurance contract. You may be able to renegotiate to include cranial prosthesis coverage.

Types of Medical Hair Loss Covered by Insurance

Most wigs covered by medical insurance are due to the following types of hair loss:

  • Chemotherapy-related
  • Kidney disease
  • Alopecia
  • Cancer
  • Thyroid issues
  • Radiation
  • Medical hair loss due to environmental changes, aging, stress, genetics, or balding

Keep in mind that some insurance companies are specific about the cause of hair loss. For example, Blue Cross Blue Shield only covers prosthesis wigs if hair loss is due to burns or chemotherapy. Verify your insurance company’s policies to ensure coverage.