Cranial Prosthesis - Get your wig covered by insurance

What is a cranial prosthesis?

A cranial prosthesis or a medical wig is a custom wig made for people who are suffering hair loss because medical reasons. Medical reasons can fall under chemotherapy, alopecia totalis, alopecia areata, trichotillomania, and other reasons that cause hair loss.

These terms are required when speaking with your insurance & for tax deductions. Other medical wig terms are cranial hair prosthesis, hair prosthesis, and full cranial prosthesis.

Are you covered for a medical wig by your insurance?

Do you have any of the following:

• Hair loss due to chemotherapy

• Kidney Related Hair lLoss

• Hair Loss Caused by Cancer

• Alopecia

• Radiation Related Hair Loss

• Hair Loss Due to Thyroid Problems

• Medical Hair Loss Due to Life and Environmental Changes, Thinning and/or Balding, Genetics, Stress, Aging, Reaction to Medical Illness (ie: blood pressure or diabetes medicine)

If yes, please follow next steps:

1. Call your health insurance and ask to speak to the benefits department.  While speaking with the benefits specialist ask them:

• Does the insurance policy you hold cover a cranial prothesis?

• If yes, what type? (They may say human hair wigs or synthetic wigs)

• How much of the cost will it cover? (A percentage or a set amount?)

• For a wig, what is the specific terminology that the prescription should have? (IE: Hair prosthesis, Cranial Hair Prosthese, Hair Prosthesis, Extra-cranial prosthesis,etc)

• To submit a claim, what required documentations are needed?

****: We strongly recommend that you call your health insurance company as opposed to reviewing your insurance policy on your own.

2. Have your doctor or dermatologist write you a prescription for a cranial prosthesis if that's the terminology your health provider said to use. Ensure the following:

• Include procedure code A9282. (Required to submit insurance claim.)
• The prescription does not say “wig”. (VERY IMPORTANT: The word wig is viewed as fashion and not considered a medical necessity.

3. Add a personal touch. By having your doctor write a letter, you become more human, and not just a claimant. In the letter, your doctor can explain hair loss and its devastating effects on a recipient. Also, he/she can state that your prosthesis is not for cosmetic reasons, but for your emotional well-being.

4. Keep ALL copies of your invoices and documentation from your doctor for medical tax exemption purposes. Consult your tax advisor regarding tax deductible items and medical bills.

IF YOU ARE GOING TO PAY UPFRONT OR OUT OF POCKET, place your order online at mycrownisroyalty.com or over the phone at 404-919-4552.

• After placing your order, email info@mycrownisroyalty.com with your order number. Let us know you need a copy of your invoice for your cranial prosthesis prescription.

• We will provide you with your invoice containing a notation that states Cranial Prosthesis and our tax ID number.

• Send all documentation to your health insurance provider. This is includes your doctor’s prescription, completed insurance claim form, invoice from mycrownisroyalty.com, and any other necessary forms.

 

What if you can't get your wig covered?

Good question, you have 4 options:

1. Schedule a consultation with us and we will call your insurance & do our best to help you.

2. If you’re paying for the wig yourself, save your receipt for possible tax deductible opportunities. Remember, if your wig is tax deductible if your medical bills exceed 7.5% of your income. Consult a tax specialist.

3. Upgrade your insurance. (Your insurance may be a default policy, ask your job's HR department (or secondary insurance broker) to negotiate your coverage contract to include cranial prosthesis coverage.

4. Speak to your social worker or doctor about local resources! Call your local division of the National Alopecia Areata Foundation, the American Caner Society, and other foundations. Depending on their requirements, you may be able to qualify for financial assistance toward a wig or hair system purchase.

What are my chances of getting covered?

• Blue Cross Blue Shield

Wigs for hair loss due to treatment of cancer. Benefits for wigs are paid at 100% of the billed amount, limited to $350 for one wig per lifetime. Does not include cranial prosthesis.

•Aetna

Reimbursement rate for participating providers of wigs (cranial prostheses) diagnosis code A9282 is $1,000.

• Tricare

You will need a prescription from your physician with the diagnosis code A9282 for a cranial prosthesis to qualify for a medical wig.

• 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.

• United Healthcare

Coverage for wigs, hair prosthesis is excluded unless specifically listed as a covered health care service