Did you know that many insurance companies have provisions for covering medically necessary wigs? Here's how to navigate the process and get your wig paid for.
What do you need?
An insurance benefit for a cranial prosthesis: Many insurance companies that cover prostheses of any kind will also cover a medically necessary wig, or cranial prosthesis, for those who experience total hair loss due to medical reasons, especially oncology. So your first point of action is to call up your insurance company and find out what it will cover and the process required for achieving coverage. Your specific budget will depend on your personal situation, diagnosis, insurance benefits, out-of-pocket limits, in-network restrictions and deductible requirements.
Diagnosis from your doctor: Obviously, for a cancer-related or medically necessary wig, you’ll need to provide a copy of the diagnosis from your doctor.
A written prescription from your doctor: Once you have your diagnosis, your doctor can prescribe a "cranial prosthesis" for you (do not say "wig"). Then, you can work with your hair replacement specialist to determine what your insurance will pay for and decide on a type of wig or treatment that fits the parameters. Sometimes your hair replacement specialists can help even further. A patient will get a prescription from the oncologist and they submit a copy of the bill with the appropriate medical code on it and can mail it to the customer's insurance company. Usually a wig is a reimbursement type of expense, but they can also have it billed directly to the customer's insurance. They abide by HIPPA (Health Insurance Portability and Accountability Act) regulations and can get the prescription from your doctor and handle all the billing. It’s actually all part of their initial consultation for a cancer-related wig.