FAQS

A cranial hair prosthesis is a custom hair system specifically designed for patients who have lost their hair due to medical conditions. These conditions include chemotherapy, alopecia totalis, alopecia areata, trichotillomania, and other conditions resulting in hair loss. It’s important to know the terminology when applying for medical insurance or tax deduction status. Other common terms used to describe a medical wig include: cranial hair prosthesis, hair prosthesis, and full cranial prosthesis.

The short answer is yes, whether you are experiencing hair loss whether temporary or permanent. Unfortunately, not many people know this. But needing a wig due to hair loss caused by alopecia, chemotherapy, or other medical conditions, is covered by many insurances. And you can file an insurance claim for the full or partial cost of your cranial prosthesis. Whether or not your medical wig is covered by your insurance company depends on your plan. But it’s possible to receive full payment for your full cranial prosthesis. However, while some insurance companies will pay for your prosthesis upfront, others require you to pay upfront and then get reimbursed.

Contact the benefits department for your health insurance and ask:

• Does your policy cover a cranial prosthesis?

• If it does, what type of prosthesis is covered (I.e. human hair wigs, synthetic wigs, etc.)

• How much of the cost do they cover?

• What specific terminology for a wig should the prescription contain?

• Is there required documentation they need to submit your claim? What is it?

Note: When reviewing your insurance policy and you don’t see cranial prosthesis listed, it doesn’t necessarily mean you don’t have coverage. We strongly recommend that you call your health insurance company and get pre-authorization.

• Get a prescription for a “cranial prosthesis” from your doctor. Make sure that’s the correct terminology required by your health insurance. Also, include diagnosis and procedure codes. It’s important that the prescription does not say “wig”. Because a wig is considered a fashion item, it is not medically necessary. The procedure code/number on your cranial prosthesis prescription is used to submit your insurance claim.

• Chemotherapy-related

• Kidney disease

• Alopecia

• Cancer

• Thyroid issues

• Radiation

• Medical Hair Loss Due to Life and Environmental Changes, Thinning and/or Balding, Genetics, Stress, Aging, Reaction to Medical Illness

Blue Cross Blue Shield, Aetna, Tricare, and United Healthcare are a few companies that offer varying coverages.

Companies that do not provide coverage:

Medicare - Because Medicare considers wigs to be cosmetic, they aren’t covered under Original Medicare Part A or B, even with a doctor’s prescription.

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.

Lillian Lee is also founder of Do Wonders, a non-profit charity organization that provides wigs to people from all walks of life undergoing cancer treatments.  Do Wonders acts as an armory for hope. Its mission to adorn women and children battling cancer with the right equipment; self-love and confidence - free of charge. If you are financially challenged and in need of a medical wig, please visit www.dowonderscharity.org.