Did You Know Health Insurance May Cover The Cost Of Your Medical Wig?
If you're experiencing temporary or permanent hair loss due to illness or genetics, you may be eligible to have the cost of your wig covered by health insurance. Whether it's caused by chemotherapy, alopecia, trichotillomania, or other medical conditions, you can file an insurance claim to receive partial or full coverage for your wig, also known as a cranial prosthesis.
Frequently Asked Questions
Wig Reimbursement Steps:
STEP 1: CONTACT YOUR INSURANCE COMPANY TO VERIFY YOUR COVERAGE
Use the following list of questions to guide your conversation with the insurance representative:- Confirm Coverage:
- Does my insurance policy include coverage for medical wigs or cranial prosthesis?
- Are HCPCS codes A9282 and S8095 applicable for billing, and are there any other codes I should be aware of?
- Eligibility Criteria:
- What are the specific eligibility criteria or conditions for coverage under my plan?
- Prescription Requirement:
- Is a prescription from a healthcare provider necessary for coverage?
- If yes, what specific terminology (i.e. cranial prosthesis, cranial hair prosthesis, etc.) should be used?
- Coverage Limit:
- What is the coverage limit or maximum benefit amount for medical wigs or cranial prosthesis?
- Provider Coverage:
- What is my out of network coverage? (Note, we are considered an “out of network” provider).
- Exclusions or Limitations:
- Are there any exclusions or limitations I should be aware of regarding this coverage?
- Claim Initiation:
- What steps do I need to take to initiate the claim process (i.e. fax, submit online, etc.)
- Where can I find the claim form?
- Required Documentation and Paperwork:
- What specific documentation/paperwork is required when submitting a claim?
- Reimbursement Process:
- How does the reimbursement process work, and what is the timeframe for reimbursement?
Note: Even if you are able to access your health coverage benefits online, we strongly recommend that you call your health insurance company and get pre-authorization / to ensure you understand the questions above.
STEP 2: OBTAIN A PRESCRIPTION FROM YOUR MEDICAL PROVIDER
Contact your healthcare provider—whether it be your dermatologist, primary care physician, oncologist, or another qualified professional—and request a prescription specifically for a "cranial prosthesis." It's crucial to use the correct terminology as required by your health insurance provider; avoid the term "wig," as it may be perceived as a fashion item rather than a medical necessity.
Ensure the prescription includes the following details:
- HCPCS Code: A9282 or S8095 (or any other procedure code specified by your Health Insurance Company).
- Diagnosis Code: Along with a clear description of the related medical condition.
As a personal touch, consider asking your doctor to include a letter detailing the impact of your hair loss on your well-being. While not always required, such a letter can emphasize that your prosthesis is essential for your emotional health and not merely a cosmetic choice. This additional documentation can strengthen the case for the medical necessity of the cranial prosthesis for you.
STEP 3: PLACE YOUR ORDER & EMAIL US TO OBTAIN YOUR INSURANCE REIMBURSEMENT INVOICE
Place your order online (www.hersavage.com) or schedule a free phone consultation if you have any questions about the process or need assistance with your order.
- Email us hello@hersavage.com with your ORDER # to request an Insurance Reimbursement Invoice for your cranial prosthesis. If there is any particular, special verbiage needed from your insurance company, let us know.
- We will provide you with your Insurance Reimbursement Invoice specifying the purchase of your cranial prosthesis along with our Tax ID & provider credentials.
STEP 4: SUBMIT YOUR CLAIM TO YOUR HEALTH INSURANCE PROVIDER
This should include:
- Your completed Health Insurance Claim Form (confirm the location of this form when you are talking to the insurance company representative)
- Your doctor’s prescription
- Insurance Reimbursement Invoice (statement we will provide)
- Any other necessary forms (per your discussion with your insurance company).
What To Do If Your Insurance Won’t Cover Your Wig Cost
Option 1. If you’re paying for the wig yourself, save your receipt for possible tax deductible opportunities. Remember, your wig may be tax deductible if your medical bills exceed 7.5% of your income. (Consult your tax professional)
Option 2. You can use one of our many Buy Now Pay Later options which allows you to buy now pay later options. These options allow you to purchase your wig with only 25% down, and break the remaining balance into installment payments (typically every 2 weeks until the balance is paid in full). Note: There is no impact on your credit nor interest added. Review further details here.
If you have any questions about this process, do not hesitate to email us or schedule a free phone consultation