How to Get Your Wig Covered by Insurance
For many individuals experiencing hair loss due to medical conditions like alopecia, thyroid, chemotherapy, or other treatments, wearing a wig is more than just a fashion choice—it’s a vital part of restoring confidence and maintaining a sense of normalcy. What many people don’t realize is that some insurance plans may cover the cost of a wig, often referred to as a “cranial prosthesis.” Here’s a step-by-step guide to help you navigate the process and maximize your chances of insurance reimbursement for your wig.
1. Understand the Terminology
The language you use in your claims can significantly affect approval rates. Insurance companies are more likely to approve claims for “cranial prostheses” than “wigs.” So, when talking with your doctor or insurance provider, remember to refer to your wig as a cranial prosthesis to help clarify that it’s a medical necessity.
2. Verify Coverage with Your Insurance Provider
Insurance policies vary widely, and each has specific terms regarding what they will and won’t cover. Here are a few questions to ask your provider:
- Does my plan cover cranial prostheses for medical hair loss?
- Are there specific requirements I need to meet?
- Is there a limit to the amount they will reimburse?
- Do I need pre-authorization?
Some insurance plans may partially cover the cost, while others could cover the entire cost, depending on your policy and the medical necessity.
3. Obtain a Prescription
Most insurance providers will require a doctor’s prescription to process a wig reimbursement. Ask your doctor to write a prescription that specifies “cranial prosthesis” if that terminology is necessary for coverage and includes the medical reason for hair loss (e.g., chemotherapy, alopecia, or other medical conditions). This prescription serves as a necessary document to show your insurer that your wig is not a cosmetic choice but a needed medical device.
4. Save Your Receipts and Documentation
Keep records of all expenses related to your wig purchase, including receipts, doctor’s notes, and prescription details. Most insurance companies will ask for proof of purchase, so ensure that the documentation is clear and itemized. This paperwork will support your claim if there’s any need to appeal a denial. Communicate with company you are purchasing from so that your receipt utilzes the proper terminology to ensure coverage.
5. Submit Your Claim
Once you have all your documentation, you’re ready to submit your claim. Here are the typical steps:
- Complete your insurer’s claims form, which can often be found on their website or requested through their customer service.
- Attach copies of the prescription, receipts, and any other required documents.
- Submit the claim through your insurer’s preferred method—this could be online, via mail, or fax.
- Be sure to make copies of everything you send in for your records.
6. Appeal if Necessary
It’s not uncommon for initial claims to be denied. Don’t get discouraged; insurance companies often deny claims that are later approved upon appeal. If your claim is denied, ask for a detailed explanation, and then gather any additional documentation needed to support your case. A letter from your doctor explaining the medical necessity of a cranial prosthesis can make a strong impact.
7. Seek Alternative Resources
If insurance won’t cover your wig or only covers part of the cost, there are other options you can explore. Some organizations offer financial assistance for medical wigs, and some wig providers work with programs that offer wigs at reduced prices for medical reasons. There are also programs, groups, and organizations that may also provide donated wigs to those who need them.
Final Thoughts
While navigating insurance can be challenging, remember that persistence often pays off. Take advantage of the support available to you from healthcare providers, social workers, and support groups. With the right documentation and advocacy, you may be able to reduce or eliminate the financial burden of your wig, allowing you to focus on feeling your best.
**Below is an example of a Wig Reimbursement Form from a Health Insurance Prover. Check with your provider for an accurate forms and requirements.
