August 8, 2017 –
Did you know? Insurance may cover the cost of your wig.
If you are suffering from a medical condition like Alopecia or Cancer that causes you to lose your hair – your wig may be covered under your current health insurance, if it is for a medical reason.
The trick is figuring out if your health insurance will cover it and how to file a claim. Insurance companies will not reimburse you if it is filed as a wig purchase, because wigs are considered a cosmetic purchase. But, if you file the claim using the phrase Cranial Hair Prosthesis, it will be paid out as a medical necessity. It will be important to have a written prescription from your doctor for a Cranial Hair Prosthesis, in addition to an explanation of how the hair loss has affected you emotionally, when you file the claim. It may also be necessary to have the written prescription before purchasing the wig or hairpiece. And when you are purchasing the wig or hair piece with us, be sure to let us know so we can indicate that it is a Cranial Hair Prosthesis and not a wig on the receipt.
Every insurance company is different and will have their own way of handling a reimbursement for a cranial hair prosthesis. Many will try to exclude or deny the claim unless it is specifically listed as a covered health service. You will want to look at the benefits your insurance company offers before filing a claim. There should be a section under “covered expenses” relating to prostheses, prosthetic devices or medical durable equipment. Be sure to follow all of the necessary requirements listed. And it might be helpful to have the following, as well:
- The item listed as a “Cranial Hair Prosthesis”
- Diagnosis Code
- NPI Code – A ten digit number given to you by your doctor
- The billing HCPCS codes: S8095 and A9282
- Our Tax ID # (Call us for this)
- Your physician’s signature and a copy of the prescription
Be sure to discuss this with your doctor and have them help you file a claim. Depending on the benefits and coverage each insurance company offers, this may not work for everyone but it is still worth a try. Check with your provider for different coverage opportunities. If you have any questions, feel free to reach out to us, and we will do our best to help you get the information you need.