Medigap Plans Can Cover Some Of Your Prostheses And Cancer Treatment Medicare Costs
To get help covering some of your Medicare out-of-pocket costs, consider enrolling in Medicare Supplement Insurance .
For example, each of the 10 standardized Medigap plans that are available in most states provide at least partial coverage for the Medicare Part B coinsurance or copayments you might face when you receive covered outpatient cancer treatments or prostheses.
A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.
Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.
Legislation To Require Medicare Coverage Of Wigs Re
Legislation to require Medicare coverage of wigs re-introduced
HME News Staff
WASHINGTON A bill that would require Medicare to cover wigs as durable medical equipment has been reintroduced in the House of Representatives.
Led by Reps. James McGovern and Ayanna Pressley, both Democrats from Massachusetts, the Wigs as Durable Medical Equipment Act , would help individuals affected by alopecia and patients with cancer who are undergoing chemotherapy.
For people impacted by alopecia or undergoing cancer treatment, a wig can make all the difference in the world, said McGovern. It can provide them with the confidence and courage they need to get back to normal during a challenging time. But wigs can cost thousands of dollars, and despite the enormous and clear benefits they provide, they are not currently covered by programs like Medicare.
Many private insurance plans cover wigs for those undergoing treatments that cause hair loss or who are affected by alopecia areata.
Pressley has been public about her own experience with alopecia.
Since I first revealed my alopecia diagnosis, Ive been intentional about creating space and creating community for those of us who have medical conditions that impact our hair – and this bill is a continuation of those efforts, she said. Every person living with alopecia, battling cancer, or facing another medical condition that leads to hair loss, should be able to access wigs and other head coverings.
How To Have Your Wig Covered By Medical Insurance
Welcome to Cranial Prosthesis Medical Wig Insurance Coverage Guide provided by Master Wig Maker Louticia Grier! If youre purchasing a wig for medical purposes, this section is for you. Is there such a thing as medical wig insurance? Absolutely, but there are several steps to determine if you qualify. Also, your health insurance needs to offer this option. Below, peruse our extensive guide to medical wig insurance claims.
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Claim A Tax Deduction
Wigs for people who experience hair loss from chemotherapy may be a medical deduction. In this case, saving the receipt could save you money on taxes. Since medical expenses must exceed 7.5 of adjusted gross income before you can claim a deduction, it may not seem worthwhile to keep track of them. Many people are surprised, however, to see how these expenses add up.
Medicare Covers A Variety Of Cancer Treatments But It Will Not Pay For A Wig
Receiving a cancer diagnosis can be scary and overwhelming. There’s a lot of information to take in and try to understand, while also preparing physically and mentally for chemotherapy, radiation, and other cancer treatments and their side effects.
Medicare covers a number of medically necessary cancer treatments, including chemo, radiation, and surgery. Side effects of these treatments can vary from person to person, but one that’s very common is hair loss.
If you experience this, know that Original Medicare does not cover the cost of a wig. However, there may be other coverage options, such as from Medicare Advantage plans.
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Mcgovern Pressley Unveil Bill To Support Individuals Experiencing Medical Hair Loss
WASHINGTON, D.C. Today, House Rules Committee Chairman James P. McGovern and Congresswoman Ayanna Pressley led their colleagues in re-introducing the Wigs as Durable Medical Equipment Act, legislation to help individuals affected by Alopecia and patients with cancer who are undergoing chemotherapy.
Many private insurance plans cover wigs for those undergoing treatments that cause hair loss or who are affected by alopecia areata. This bill would allow cranial prosthetics to be covered under the Medicare program. The full text of the bill is available here.
For people impacted by Alopecia or undergoing cancer treatment, a wig can make all the difference in the world. It can provide them with the confidence and courage the need to get back to normal during a challenging time, said Rep. McGovern. But wigs can cost thousands of dollars, and despite the enormous and clear benefits they provide, they are not currently covered by programs like Medicare. Congresswoman Ayanna Pressley and I think that needs to change, and we are introducing this important new bill to ensure equitable access to wigs and extend dignity and respect to folks who are impacted by Alopecia or who are undergoing cancer treatment.
Reps. McGovern and Pressley were joined by Rep. Mike Quigley in introducing the bill.
Do Medicare Advantage Plans Help Pay For Wigs
Original Medicare doesn’t cover wigs, but some Medicare Advantage plans do. Sometimes just a portion of a wig is covered, but there are also other free options for head coverings, including wigs.
The key to getting your wig covered is making sure the prescription is written out appropriately. Here are a few steps for how to get coverage from your Medicare Advantage plan.
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Does Medicare Cover Wigs For Cancer Patients
Hair can be a unique expression of someones style, cultural identity even their personality. As a very personal and important part of ones identity, its understandable why cancer patients find hair loss uncomfortable and jarring when they begin to experience it after starting cancer treatments like chemotherapy and radiation.
Medicare Benefits Solutions
According to research, some cancer patients feel that they become less attractive without hair and with each strand that falls out, so leaves a part of their individuality. In addition, being diagnosed with cancer and undergoing treatment comes with so much trepidation as it is. So for many, adding the side effect of hair loss can be traumatizing.
Doctors may prescribe wearing a wig or some other hair prosthetics for those patients who feel they will lose a part of themselves with hair loss from chemo and radiation. Wigs for cancer patients can help them maintain or reclaim self-confidence. It can also make it easier for them to feel comfortable while continuing vigorous treatments and during their recovery.
How to Handle Cancer-Related Hair Loss
People may lose their hair while receiving chemotherapy drugs because of the drugs dosage and the duration of the patients treatment with them. The side effect of hair loss is also likely to occur when patients have radiation that concentrates primarily on their heads.
Preparation for Wig-Wearing
Does Medicare Cover Dermatology For Hair Loss
In some cases, you may seek a surgical procedure, such as a hair transplant, as a more permanent solution for hair loss. In order to undergo such a surgical procedure, youll need to visit a dermatologist. This may have you wondering, Does Medicare cover dermatology for hair loss?
Unfortunately, the answer is typically no. While there are many excellent dermatological treatments for hair loss, they are still considered to be cosmetic and are not covered by Medicare. Types of dermatological hair loss treatment that are not covered by Medicare include:
- Hair transplants
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Work With A Specialist
When doing research, you’ll find that there are many shops that specialize in creating wigs for cancer patients. Sometimes, these shops may help you file the insurance claim for wig coverage. Or, they may help you through the paperwork and answer questions you may have. Either way, finding a shop and working with them can make getting a covered wig easier.
Does Insurance Pay For Medical Wigs
Most private health insurance companies do actually cover some or all of the cost when it comes to wigs and hair prostheses, as long as you have a written prescription from your doctor.Unlike medicare, these health insurance companies do consider wigs to be medical necessities if your hair loss is a direct result of your health condition.
For medical-related hair loss, most health insurance companies will cover 80%-100% of your wig or hair prostheses. They will also allow you to get one wig per year as long as its due to medical-related hair loss. Some insurance companies may require you to pay for the wig then they reimburse you at a later stage, others may cover the costs for you upfront.
Your wig may also be tax-deductible, depending on the insurance company that youre with. For example, with some insurance companies if your medical bills are more than 7.5% of your salary then your wig will be tax-deductible.
Insider Tip: If you want to get tax deductions on your wigs or get your medical insurance to pay for it then you need to list it as a cranial prosthesis.
Types Of Medical-Related Hair Loss Covered By Insurance
- Chemotherapy-related hair loss
- Cancer-related hair loss
- Medical-related hair loss from stress, genetics, environmental changes, life changes, and aging
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If Your Insurance Won’t Help Cover The Cost Of Your Wig
Option 1: When paying for your wig out of pocket, save the receipt just in case your purchase qualifies as a tax deduction. If a person’s medical bills are over 7.5% of their income, then the wig would become tax deductible.
Option 2: Talk with your doctor or social worker about local resources! Contact your local chapter of the American Cancer Society, National Alopecia Areata Foundation , and other foundations about qualifying for financial assistance toward the purchase of a hair piece or wig.
What Other Options Are Available To Cover Hair Loss Due To Cancer Treatments
Wigs aren’t the only option for people experiencing medically related hair loss. Some individuals prefer accessories such as hats, caps, scarves and bandannas to maintain normalcy and protect sensitive skin from exposure to the sun.
Several organizations offer complementary accessories to women, teenagers and children experiencing hair loss due to illness or cancer treatment:
- Chemocessories provides free custom scarves and turbans to women experiencing medically related hair loss. You can request these one-of-a-kind items online.
- Hope Scarves offers free scarves to anyone facing a cancer diagnosis. Scarves may be requested via their online form.
- Through the Battle Cap Project, individuals suffering medically related hair loss may request a free handmade knit cap by filling out a brief online form.
- Good Wishes offers a free wrap to anyone experiencing hair loss related to an illness or cancer treatment. Wraps may be requested by calling 778-5998, or completing an online request form.
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Where Can I Purchase A Wig
If you’re living with hair loss or thinning caused by treatments for cancer or other serious illnesses, there are several places you can purchase high-quality wigs in a variety of colors, lengths and styles:
- Wig shops: Your hospital’s cancer center or an organization specializing in helping cancer patients should be able to direct you to reputable nearby wig shops. These stores typically feature a multitude of styles at various price points, which you can browse through and try on. At a wig shop, you should also be able to consult with knowledgeable stylists and get fitted for a high-quality wig.
- Wig specialists: If you can find a local wig specialist, they often make home visits to discuss options and to fit you professionally for a wig. Wig specialists may also offer tips for the care and styling of your chosen wig.
- Online retailers: Online retailers let you shop for wigs in the privacy of your own home. They typically have the largest selection of wigs available, and they may offer consultations over the phone or via an online chat.
Unfortunately Medicare Does Not Typically Cover Hair Loss Treatment
Medicare plans, from Original Medicare to Part D Prescription Drug Coverage and Medigap supplemental plans, typically do not cover procedures considered to be cosmetic. Unfortunately, hair loss treatment typically falls under the umbrella of what Medicare considers cosmetic, even if you have a genetic condition that causes hair loss, such as:
- Alopecia areata
- Alopecia totalis
- Alopecia universalis
- Androgenetic alopecia
This means that if you have Original Medicare and/or Medicare Part D Prescription Drug coverage, they will not provide coverage for most of the hair loss treatments that you seek. This includes any prescription medications designed to stimulate hair growth. If youre seeking hair loss treatment, youll have to cover 100 percent of the costs on your own.
If youre seeking hair loss treatment, but are afraid to get it because you fear it wont be covered, dont let that hold you back. In some rare cases, Medicare Part B may cover certain hair loss medications if they are administered by a medical professional, such as a doctor or nurse practitioner, in a healthcare facility. In order to have such treatments covered, the medications must be deemed medically necessary by your doctor and by Medicare. The healthcare provider administering the treatment must also accept Medicare assignment.
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What Is A Cranial Prosthesis
A cranial hair prosthesis is a custom hair system specifically designed for patients who have lost their hair due to medical conditions. These conditions include chemotherapy, alopecia totalis, alopecia areata, trichotillomania, and other conditions resulting in hair loss.
Its important to know the terminology when applying for medical insurance or tax deduction status. Other common terms used to describe a medical wig include: cranial hair prosthesis, hair prosthesis, and full cranial prosthesis.
Rep Ayanna Pressley Joins Reintroduction Of Bill To Get Wigs Covered By Medicare
It’s been more than two years since Representatives James McGovern and David Schweikert introduced a bipartisan bill that would see to it that wigs would be covered by Medicare for people undergoing treatments that cause hair loss, like chemotherapy, or those who are affected by alopecia, an autoimmune disease in which the body attacks its own hair follicles and can lead to partial or total hairlessness. H.R. 3332, however, stalled in Congress that is until Congresswoman Ayanna Pressley brought her first-person experience and advocacy to the table to join McGovern in reintroducing the bill.
The bill, known as the Wigs as Durable Medical Equipment Act, was reintroduced on Friday, October 1. It recognizes that, while some private insurance companies cover the cost of cranial prosthetics, the often-expensive wigs are not covered by Medicare, leaving many low- and fixed-income patients without the resources they need something with benefits that go far beyond cosmetic.
Representative Mike Quigley joins Pressley and McGovern on the bill, which proposes to amend title XVIII of the Social Security Act. The full text of the bill can be found here.
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What To Do If Your Insurance Wont Cover Your Wig Cost
Option 1. If youre 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.
Option 2. 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 quality for financial assistance toward a wig or hair system purchase.
What Cancer Treatments Does Medicare Cover
When it comes to cancer coverage, there are primarily two types offered by Original Medicare: Preventive screenings and treatments.
Preventive screenings are covered by Part B and include exams, lab tests, and other diagnostic screenings used to detect disease early, while it’s easier to treat. There are several preventive screenings designed to detect cancer early including:
Then, depending on whether you’re an inpatient or an outpatient, chemotherapy and radiation are covered by Part A or Part B.
Both chemotherapy and radiation are covered by Part A if you’re a hospital inpatient. Part B applies if you’re an outpatient or patient in a doctor’s office or freestanding clinic.
As an inpatient, you’d pay the Part A deductible and coinsurance . If an outpatient, you’d pay a copayment, and the Part B deductible applies. At a freestanding facility, you’d pay 20% of the Medicare-approved amount .
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Is Cancer Treatment Covered By Medicare
If you have cancer and youre a hospital inpatient, Medicare Part A will typically cover your chemotherapy.
If you receive outpatient treatment in a hospital, doctors office or a clinic, Part B will typically cover your chemotherapy sessions.
One of the most common side effects from chemotherapy and radiation therapy in cancer patients is hair loss. A wig may make beneficiaries more comfortable throughout their cancer treatment.
Medicare Part A and Part B do not, however, typically cover wigs.
Medicare Coverage Of Wigs For Cancer Patients
Medicare covers medically necessary treatment, items and services. Wigs are not considered to have medical value in treating hair loss and, as a result, there is no Medicare coverage available to help pay for a wig.
A Medigap plan, which helps with some of the costs not covered in Original Medicare, would also not cover wigs.
Wigs can benefit cancer patients by offsetting some of that trauma and offering a way to maintain their appearance throughout the treatment process.
According to BreastCancer.org, wearing a wig can also help some people feel more normal and have consistency in their appearance.
While wigs are not covered, Original Medicare does cover other services and items related to cancer treatment, such as:
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