CUSTOM WIGS

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A cranial prosthesis is a wig for medical patients who have permanent hair loss (such as alopecia areata, alopecia totalis, trichotillomania), or temporary hair loss resulting from treatment for chemotherapy, radiation, or any other clinical disease.

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, and extra-cranial prosthesis.

Since the above processes are an ongoing condition, you may be eligible to receive full or partial coverage to purchase the full cranial prosthesis from your health insurance company.

For medical hair loss, you may obtain payment for the full cranial prosthesis. Depending on your policy, some insurance companies will require you to pay upfront and then be reimbursed, others will pay for your prosthesis upfront.

Most insurance companies will cover between 80-100% of the cost for your full cranial prosthesis and will allow you to receive one cranial prosthesis per year for medical hair loss. 

Depending on your insurance, your prosthesis may also be a tax-deductible medical expense. We confirmed with insurance representatives that if a person's medical bills are over 7.5% of their income, then the wig would become tax deductible. However, the individual should discuss this with their tax advisor first.

Through research, we discovered that in default policies there is no coverage for wigs as they are part of the Standard List of Exclusions. However, you can contact your employer's HR department or your insurance broker to renegotiate your insurance contract to include your cranial prosthesis coverage.

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.

FOLLOW THE STEPS BELOW:

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 do they need to have on the prescription for a wig
• What specific documentation do they need to submit your claim?

Please note that 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 STEP:

Request and obtain a prescription for a “cranial prosthesis” (or the specific terminology required by your 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/Diagnosis code for your cranial prosthesis that will be used to submit your insurance claim. 

You may also Ask your physician to 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.

Keep copies of all of your documentation and invoices from your physician for tax exemption purposes. You will need to your tax advisor first about medical bills and tax-deductible opportunities.