If you have experienced hair loss due to chemotherapy or radiation treatments then you’re probably familiar with wig-wearing. Wigs can be costly, so it’s no surprise if you want to know if Medicare covers the cost!
Original Medicare (Parts A and B) don’t cover wigs or hair prostheses, even if your doctor prescribes it. However, if you have a Medicare Advantage plan (Part C), there may be options available to you when buying wigs or hair prostheses. That said, the benefits on Medicare Part C can vary based on location so check the list of benefits beforehand.
If you’re interested in learning more about the likelihood of getting medical insurance companies to pay for your wigs as well as how to go about getting them to pay for medical wigs, keep reading! It’s worth your while!
Does Medicare Pay For Cancer Wigs?
Unfortunately, Medicare does not cover cancer patients’ wigs, even if cancer treatments have caused hair loss. Medicare still does not consider wigs as medical necessities. There is a silver lining; if you are on a Medicare Advantage plan, your wig might just be covered if your hair loss is a direct cause of cancer treatments.
Depending on your plan, you may be able to purchase a wig to wear during your cancer treatments. The only tricky part is that Medicare Advantage benefits differ from place to place so you will need to check the range of benefits for Medicare Advantage people in your area to see if wigs or hair prostheses are on the list.
An insurance agent will be able to assist you in comparing the different Medicare Advantage plans that are available to people in your area so that you are aware of the coverage that they provide.
What If Your Medicare Plan Does Not Cover Wigs?
If all else fails and the coverage for your area does not include wigs or hair prostheses then try talking to the nurses and counselors at your treatment centers. If there happen to be any local organizations that provide cancer patients with wigs, they’ll be able to steer you in the right direction.
Whilst Medicare may not be able to pay for your medical wig, let’s take a look if private health insurance companies can be of any help. Keep reading to find out!
Does Insurance Pay For Medical Wigs?
Most private health insurance companies do actually cover some (80%) or all of the cost when it comes to wigs and hair prostheses, as long as you have a written prescription from your doctor. Unlike medicare, these health insurance companies do consider wigs to be medical necessities if your hair loss is a direct result of your health condition.
For medical-related hair loss, most health insurance companies will cover 80%-100% of your wig or hair prostheses. They will also allow you to get one wig per year as long as it’s due to medical-related hair loss. Some insurance companies may require you to pay for the wig then they reimburse you at a later stage, others may cover the costs for you upfront.
Your wig may also be tax-deductible, depending on the insurance company that you’re with. For example, with some insurance companies if your medical bills are more than 7.5% of your salary then your wig will be tax-deductible.
Insider Tip: If you want to get tax deductions on your wigs or get your medical insurance to pay for it then you need to list it as a cranial prosthesis.
Types Of Medical-Related Hair Loss Covered By Insurance
- Chemotherapy-related hair loss
- Radiation-related hair loss
- Alopecia-related hair loss
- Thyroid-related hair loss
- Kidney-related hair loss
- Cancer-related hair loss
- Medical-related hair loss from stress, genetics, environmental changes, life changes, and aging
Keep in mind that most policies do not include coverage for wigs, this does not mean that you can’t get it! Contact your insurance broker or your employer’s HR department to negotiate the conditions of your insurance contract in order to make sure that you have cranial prosthesis coverage.
Now that we know that there are medical insurances that are willing to pay for your wig or hair prostheses and what they’re actually willing to pay for, let’s take a look at how you can go about making them pay. If you’re interested in learning more, take a look below!
How To Get Your Wig Covered By Medical Insurance
I’m sure you’re eager to find out exactly how to go about getting your medical insurance to pay for your wig, so without further ado. This is what you need to do:
To get your wig covered by medical insurance, request a prescription for a cranial prosthesis (or the specified term from your Health Insurance) from your doctor. Make sure that the medical procedure code A9282 is included in your prescription. Also, ask your doctor to write a detailed letter explaining your medical-related hair loss
Keep reading to get a detailed step-by-step method of how to get your wig covered by your medical insurance.
Step 1: Contact Your Health Insurance Company To Find Out:
- If the policy you are on covers cranial prostheses
- What cranial prostheses are covered (human hair or synthetic wigs)
- How much of the cost for the wig they will cover
- What specific wording or terminology is required on the prescription for your wig
- What specific documentation you need to submit so that they can process your claim
Step 2: Get The Prescription
Request a prescription for a cranial prosthesis (or the specified term from your Health Insurance) from your doctor. Make sure that the medical procedure code A9282 is included in your prescription.
Step 3: Go The Extra Mile
In addition to the prescription, ask your doctor to write a detailed letter explaining your medical-related hair loss and also have them specifically state that your cranial prostheses are not for cosmetic reasons but rather your emotional well-being.
Step 4: Keep Copies Of Important Documents
Make sure that you make copies of all the documents and invoices from your physician. This will come in handy for tax exemption purposes. If you’re not sure how to claim your tax deduction on your wig, speak to your tax advisor about your medical bills and your tax-deductible opportunities.
Insider Tip: If you would like an in-depth, step-by-step instruction on how to get tax deductions from your wigs, then simply click on this link HERE. It will give you all the info you need to know and how to go about filing your claims.
Step 5: Request An Invoice For Your Wig
When you have purchased your wig, request an invoice and state that you need it for your cranial prosthesis prescription. In addition, request the Tax ID number of the wig company that you purchased your wig from. This will help later with claiming tax deductions.
Step 6: Forward Your Documents
Send all your documentation to your medical insurance provider. These include:
- Doctors prescription
- Copy of your invoice from the wig store
- Completed insurance claim form
- Any additional supporting documents
What to do if your insurance doesn’t cover wigs?
If you find that you don’t have coverage for cranial prostheses or you just don’t want to go through the hassle of filing insurance claims, then there are still options available to you. You can get in contact with the American Cancer Society, they offer free or reduced-cost wigs to anyone who is undergoing cancer treatment.
You can get in contact with them by going online, reaching out to your local branch of the American Cancer Society, or even reaching out to the counselors at your treatment center!