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Insurance Coverage For “Wigs”

Insurance Coverage Opportunity

Did you know?

If you require a ‘wig’, or the medical term “cranial hair prosthesis,” while experiencing Alopecia or, undergoing a cancer related therapy, you may be eligible for reimbursement under your health insurance plan.

If you need to wear a wig because of a medical condition such as Alopecia, or cancer-related therapies, the “wig” should be referred to as a ‘cranial hair prosthesis’ for insurance purposes.  If you file an insurance claim for reimbursement for a “wig” instead of a “cranial hair prosthesis”, you will very likely be turned down. Most insurance companies cover between 80% to 100% of a cranial prosthesis.

We are here to help you.

Insurance Companies are realizing that cranial hair prosthetics are a necessity for those dealing with Alopecia or for people experience hair loss due to cancer treatments.  Follow some simple guidelines to assure coverage, when it is available through your insurance company.  Your physician should be able to supply all the details and make the referral for the purchase of your “cranial hair prosthesis”. You will need to ask your physician to give you a “Cranial Prosthesis” prescription.

When receiving your hair prosthesis, have your stylist complete an invoice for a “cranial hair prosthesis” NOT a wig and use the following guidelines for filing an insurance claim.

• Check the benefits of your insurance. There should be a section under “covered expenses” relating to prosthesis, prosthetic devices or medical durable equipment. Most Insurance companies don’t spell out exclusions, so pay attention to the actual coverage. This will help your case.

• Make sure to complete the insurance form and have it signed by your physician.

• Request that your physician write a “prescription” for a “full cranial prosthesis” (not a wig) and a letter explaining hair loss and its effects. That it isn’t just for cosmetic reasons but for emotional well-being as well.

• Keep copies of your sales or invoices for your cranial prosthesis. (Portions of unpaid items by insurance are tax deductible.)

• Enclose a letter to the insurance company stating the necessity of a prosthesis.

  • Some optional suggestions are  – include a letter from your employer, – take pictures of yourself without hair, – hand write a letter detailing the emotional effects that your condition has had on your life, – bring a copy of your prescription and paid bill to the American Cancer Society for partial reimbursement.

How to File Your Initial Insurance Claim

  1. Receive a letter or prescription from your doctor for a “Cranial Hair Prosthesis.”
  2. Use the Healthcare Common Procedure Coding Systems (HCPCS) codes: S8095 and A9282

S8095 : Wig (for medically-induced or congenital hair loss),

HCPCS A9282 Wig, Any Type, Each Prior Authorization only required if purchase price is over $500.00

  1. Have a receipt from the company where you purchased your Cranial Hair Prosthesis. Make sure it does not say “wig” anywhere and that it includes the HCPCS insurance codes.  *WE CAN HELP WITH THIS*
  2. Also have the company include their Tax ID#.
  3. Have your physician sign off on the insurance claim form.
  4. Double check your insurance claim form to make sure you legibly included the following elements:
  • The item “Cranial Hair Prosthesis”
  • The HCPCS codes: S8095 and A9282
  • The company’s Tax ID #
  • Your physician’s signature.

Appealing a Denied Insurance Claim

  1. Know your rights and be informed. Obtain a copy of your full contract with your insurance company.
  2. Carefully read and understand the exclusions (“wigs”) and covered items (“Cranial Hair Prosthesis”) in your policy. See if your insurance policy calls it something other than “prosthesis.”
  3. Write a letter to the Medical Review Board asking for a review. Be sure to attach a copy of original claims.
  4. Emphasize that a wig is a cosmetic item and unnecessary. Prosthesis however, is necessary (comparable to plastic surgery for a burn victim).
  5. Address your letter to a supervisor in the Claim Department and ask for a written reply.
  6. Some other suggestions are:
  • Include pictures of yourself without hair and a letter detailing the emotional effects your hair loss has had on your life
  • Include a letter from your employer

Due to the differences in every individual’s insurance policy, this may not work for everyone. This guideline is just for you to reference and to show you how to research if your insurance company covers “Cranial Hair Prosthesis” or something similar. Make sure you review and understand the procedures outlined by your insurance policy as it may differ between carriers.  Keep copies of all documentation including the receipt/invoice for your Cranial Hair Prosthesis (may even be a  tax deductible medical expense).

Marquesa Hair offers Medical wigs for cancer patients, Alopecia , Trichomania patients in different styles and beautiful colours.

You may be asking yourself, Which wigs is the Best Wigs for me?

There are many hair cap constructions found in the different designs of wigs for patients going through medical treatment. Many cancer patients can wear any conventional wig with a standard wefted cap. There are, however, several different types of constructions in hairpiece caps of wigs for cancer patients that provide specific benefits and may be the answer to some unique individual needs. Whether you chose ultra light weight caps, monofilament caps, Thin Skin or Lightweight Stretch Cap, full hand-tied cap, lace front cap or glueless cap, we will make sure you are extremely comfortable in it.

Marquesa will like you to understand the options and differences in all types of wigs for cancer patients.

Monofilament medical wigs for cancer patients from are especially the PERFECT choice for those with severe or total hair loss because OUR monofilament wig caps are constructed with a soft, silky and hypoallergenic material. 

Standard wig or “wefted wig”caps are made from cloth and may be itchy or irritating to those with sensitive scalps. For this reason, our monofilament wigs will work best for you.

Our Thin Skin Wig Caps are designed for maximum comfort. This type of caps are constructed of a thin polyurethane. This specific wig cap is designed for patients with no hair growth, or Alopecia Totalis.

On the other hand,  Marquesa’s silk mesh caps of monofilament wigs for cancer patients are the Ultimate choice for comfort while allowing for versatile hair styling.

Light Weight Stretch Cap

Marquesa Wigs with lightweight stretch caps (top, ear to ear, or back) are another option in design choices of wigs for cancer patients. These wig caps, for cancer patients, are cool, lightweight and secure, and are especially comfortable during the heat and humidity of summer.

If you have an extremely sensitive scalp, we recommend a unique wig cap that is worn between your head and any of our wigs, regardless of your medical condition. The CORRECT cap allows you the freedom to use just about any hairpiece as wigs for cancer patients. We have an array of wigs designed with you in mind.  If you preferred to have a custom made unit, we would be more than happy to assist you in any decision making.  Please be confident, our staff is highly trained and will make your journey a little bit lighter.  

Please visit our showroom at Salon & Spa Renova, 3105 grand Avenue, Coconut Grove, Florida 33133 or glance our website for many different options. WIGS CAP CONSTRUCTION

Thank you for your interest,

The Marquesa Team.