Will Insurance Cover The Cost Of A Medical Wig?
If you have a medical condition such as Alopecia, Trichotillomania or you're a cancer patient looking for a chemotherapy wig for hair loss, you may have insurance coverage to offset the cost of your medical wig.
Call Your Health Insurance Provider First
Most private health insurance policies will cover a percentage of a wig purchase. Before you start wig shopping, call your insurance company and ask about their requirements, what they will cover and what terminology they need to have on a prescription for a wig.
It’s important to know that in order to qualify, most insurance companies, require a qualifying medical diagnosis given by your treating physician which could make you eligible for reimbursement for your medical wig also called Cranial Prosthesis. The insurance company may also require that you purchase the wig first, send in the receipt, and file a claim.
When looking over your insurance policy to verify your coverage the information will likely be listed under the section called: Durable Medical Equipment.
Note: Just because you don’t see cranial hair prosthesis listed, it does not
automatically mean you don’t have coverage. Approval can be obtained by calling your insurance company and getting a pre-authorization.
When filing your claim for insurance coverage for your medical wig, it’s vital that you use the correct terminology and diagnosis codes assigned by your prescribing physician when submitting your reimbursement claim.
Some common terms for medical wigs include:
- cranial prosthesis (CP)
- hair prosthesis
- cranial hair prosthesis extra-cranial prosthesis
FILE FOR INSURANCE
Follow the instructions below to file an insurance claim for your wig / medical hair prosthesis.
STEP 1. Pre-Authorization (Get Pre-Approved)
Approval can be obtained by calling your insurance company and getting a pre- authorization. Call your insurance company and ask about their requirements, what they will cover, and what terminology they need to have on a prescription for a wig.
Search our website for the wig you like to get a cost estimate, then ask your insurance provider how much they will reimburse you for your medical hair prosthesis, and how long it will take to get reimbursed.
STEP 2. Purchase Your Wig
STEP 3: File a Claim
Download and send Claim Form #1500 to your insurance company (contact your provider if the form is not listed below). Other items you will need include:
- Our Federal Tax ID: #
- Procedure Code from your insurance provider. Commonly used procedure codes: Synthetic Wig (A9282 or 99199); Human (L8499)
- Receipt paid in full as proof of payment
- Prescription (Rx) with your diagnosis code from your doctor (It must be written for a medical or cranial hair prosthesis)
Grant Coverage for Medical Wigs:
Thanks to the NAAF (National Alopecia Areata Foundation) many people are receiving assistance with the purchase of lace wigs! NAAF developed and manages a special program called the Ascot Fund. This pre-purchase program provides financial assistance towards the purchase of custom made lace wigs. The program is open to individuals who suffer from alopecia or similar conditions and are experiencing financial hardship. Since its start in 2004, hundreds of individuals have benefited from this fund.
You are eligible for the Ascot Fund if you meet the following requirements:
* have been diagnosed with alopecia areata by a dermatologist or doctor, * are unable to purchase a hairpiece due to financial challenges,
* are not already in possession of the hairpiece shown on the application, * have not already paid for the full balance of the cost of the hairpiece.
(The Ascot Fund is a pre-purchase program; reimbursements are not provided for any purchases paid in full either by credit card or other financial means).
The maximum amount awarded is $500. The applicant needs to be able to pay any balance beyond the award amount.
Follow the guidance below to find out if you qualify for a grant towards your custom lace wig.
To obtain the forms please call 415-472-3780 or E-mail: firstname.lastname@example.org and ask for the Ascot Fund Application form.
Select the lace wig that you would like from our website. We will not require payment from you at this time.
Request your Dermatologist's signature on the DIAGNOSIS FORM
Take special care when completing your application ensuring that all the steps are complete. The more information you provide the quicker your application can be processed. Omitted or incomplete information can cause a delay in your application process.
Once your application is approved, you will be notified by the NAAF. In that time we will begin constructing your custom lace wig.