Medicare Benefits For Recipients With Cancer Who Need Wigs
Your doctor may prescribe a hair prosthetic like a wig or other cranial prosthetics for hair loss experienced while receiving cancer treatments. Medicare Part B covers many prosthetic devices known as durable medical equipment or DME. There are Medicare benefits to cover the costs of these devices because of their medical necessity. They often replace a body part or play a significant role in the proper functioning of a persons body.
Unfortunately, when it comes to hair prosthetics like wigs, Medicare doesnt deem them medically necessary and will not cover the cost. However, some Medicare Advantage plans offered by private insurance companies provide wig coverage for recipients with a doctors prescription.
To determine if your Medicare Advantage plan has this particular benefit and find out your associated shared cost responsibilities, make sure you contact a benefits coordinator or plan administrator for more information. You can also review any plan documents that the plans insurance sent you.
TIP: If you are looking for additional benefits, try our plan finder tool and compare Medicare plans side-by-side.
To get more of your Medicare questions answered, subscribe to our free monthly newsletter
How To Submit Medicare For A Wig
For some individuals, one of the most devastating emotional costs of a battle against cancer is hair loss. While modern cancer drugs pose less of a hair loss problem than previous generations of chemotherapy drugs, hair loss remains a problem for thousands undergoing treatment.
Medicare does not directly pay for wigs, even with a prescription or when the hair loss is due to a medical condition. However, you may have some other options.
1. Obtain a prescription for a wig or hairpiece. Your doctor may agree to write one if you are losing hair due to cancer, chemotherapy or a related condition, or simply due to a skin or scalp disorder.
2. Enroll in Medicare Part B. This is an optional Medicare program that covers physician services and durable medical equipment costs, as well as lab fees. You will probably have to await an open enrollment period and pay a monthly premium. Medicare Part B does not pay directly for wigs however, it is a prerequisite for participation in Part C, Medicaid Advantage.
3. Enroll in Medicare Advantage, Part C. This is a way for eligible seniors to access their Medicare benefits through contracting with a managed care company. Medicare does not pay for wigs, but some managed care companies do. Individual plans vary, so check with the managed care company sponsoring your plan. Again, you will likely have to wait until your open enrollment period to apply for Medicare Advantage.
Does Medicare Cover Radiation Treatments
Part B. covers radiation administered at a doctors office or clinic. This is because Part B covers outpatient services.
If you receive radiation treatment during a hospital stay, its covered under Part A. Inpatient services have coverage through Part A.
Find Medicare Plans in 3 Easy Steps
We can help find the right Medicare plans for you today
Read Also: Is Medicare Advantage A Good Choice
Where Can I Find A Wig
Search your local area and phone book for wig stores. If you are worried about privacy, ask if the store has one-on-one service available for cancer patients who are choosing a wig. Some may even have a private area for trying on wigs.
If you have a cancer support group near you, you might want to ask others in the group about places to buy a wig. You can also ask your nurses or a social worker at your treatment center about wig buying options.
There are also online retailers like “tlc“ that sell wigs and other head covering options.
Check the wig return policy and your insurance policy:
- Make sure you can return the wig within a reasonable length of time without a restocking fee.
- Check your private insurance policy. With a prescription from your doctor for a cranial prosthesis or “hair prosthesis,” it may help cover the cost of a wig.
- Unfortunately, Medicare Parts A and B do not cover the cost of wigs for people going through cancer treatment, but they may be a tax-deductible expenses.
Will Insurance Cover The Cost Of A Wig
Partial or complete baldness from conditions such as cancer treatment, alopecia, and trichotillomania relate to medical causes of hair loss. For these individuals, there may be ways to offset or even completely cover the cost of the wig, which, for medical purposes, is called a cranial prosthesis. Regardless of how you pay for your cranial prosthesis, keep copies of all related paperwork: doctors prescription, sales receipt, insurance claim forms, and all correspondence with the insurance company.
Read Also: What Is The Medicare Expansion
Finding A Wig That Matches Your Hair Texture Will Require Research
Black women often have a hard time finding wigs that match Black hair color or texture. A majority of available wigs, particularly those covered by insurance, have straight hair rather than curly or kinky hair, leaving some women no choice but to spend hundreds of dollars to have a wig made. For this reason, a few organizations are now helping Black women find a wig that suits them.
After being diagnosed with breast cancer in 2015, Dianne Austin was inspired to cofound Coils to Locs, an organization that sells wigs wholesale to hospitals and hair salons. Although its wigs arent available directly through the organization, you can ask your local salon or hospital if it offers any Coils to Locs wigs, or reach out to the organization to connect it to your salon or hospital.
For the Breast of Us seeks to assist and empower women of color battling cancer. Cofounded by CEO Marissa Thomas following her own cancer diagnosis, the organization does not directly give away or sell wigs but instead offers advice on how to find wigs and resources for women of color.
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.
Don’t Miss: How Much Is Medicare Plan F Cost
Find Inexpensive Or Free Wigs
If you know in advance that insurance will not help with a wig purchase, shop around for inexpensive wigs. Contact a local chapter of the American Cancer Society about donated wigs that are available at no cost. A number of other organizations also offer free or discounted wigs, and a social worker or patient navigator at the cancer center may be able to direct you to the appropriate resources.
Ready To Find Your Plan
For California residents, CA-Do Not Sell My Personal Info, .
This Website serves as an invitation for you, the customer, to inquire about further information regarding Medicare Supplement insurance, and your call will be routed to a licensed agent who can provide you with further information about the insurance plans offered by one or more of our third party partners. Submission of your contact information constitutes permission for an agent to contact you with further information, including complete details on cost and coverage of this insurance.
We and the licensed agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program. Medicare has neither reviewed nor endorsed the information contained on this website. This is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE , 24 hours a day/7 days a week or consult www.medicare.gov.
You May Like: Can You Get Dental Implants With Medicare
Medicare Advantage Plans May Cover Other Cancer And Non
Medicare Advantage plans are sold by private insurance companies as an alternative to Original Medicare.
Every Medicare Advantage plan must cover everything that Part A and Part B covers. This means that your cancer treatments that would be covered by Original Medicare would also be covered by a Medicare Advantage plan.
Most Medicare Advantage plans also cover prescription drugs, which can include oral cancer drugs and oral anti-nausea drugs when used as part of an anti-cancer chemotherapy regimen.
Depending on your plan, a Medicare Advantage plan may provide benefits to obtain a wig during cancer treatment, though a plan that does may not be available where you live. You should check with your plan carrier to learn more about your plan benefits and coverage.
Some Medicare Advantage plans also offer additional benefits, such as:
Will My Health Insurance Cover The Cost Of My Medical Wig
The short answer is YES medical insurance covers pay for wigs fully or partially depending on their terms and conditions. Unfortunately, not many cancer patients are aware of this.
This goes for any other medical conditions that may lead to hair loss and require you to wear a wig like alopecia.
However, so many things factor in determining whether your insurance will cover your wig or not. For example, the terminology you use to apply for a wig is crucial, and a record of your paper trail is even more critical.
Read Also: Does Medicare Help Cover Assisted Living
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 .
Insurance Companies And Cranial Prosthesis Coverage
Blue Cross Blue ShieldWigs 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.
AetnaReimbursement rate for participating providers of wigs diagnosis code A9282 is $1,000.
TricareYou will need a prescription from your physician with the diagnosis code A9282 for a cranial prosthesis to qualify for a medical wig.
MedicareBecause Medicare considers wigs to be cosmetic, they arent covered under Original Medicare Part A or B, even with a doctors prescription.
United HealthcareCoverage for wigs, hair prosthesis is excluded unless specifically listed as a covered health care service.
Information provided in this is based on U.S. Health Insurance Companies only. Information updated on June 20, 2021.
You May Like: Does Medicare Pay For A Nutritionist
Rep Ayanna Pressley Joins Reintroduction Of Bill To Get Wigs Covered By Medicare
Its 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.
More on hair loss:
Recommended Reading: Does Medicare Cover Lung Cancer Treatment
Benefits Of Wearing A Wig During Cancer Treatment
The encouraging news is many wigs look very natural and offer some unexpected benefits, which may include:
- Confidence boost: We express our individuality through our appearance, which often includes styling our hair. While some people feel confident without a wig, others enjoy a confidence boost from wearing a wig during treatment.
- Freedom to experiment: While you can certainly replicate your normal hairstyle with a wig, you can also have fun trying out new hair colors and styles. You can even have a few different styles on hand, giving you the flexibility to mix up your look whenever you want.
- Simple routine: Most wigs are easy to take care of, only needing the occasional wash and style. This allows you to enjoy a simple routine.
- Empowerment: Wearing a wig gives you the chance to feel empowered. While you cant control the hair loss, you can control how you look during cancer treatment.
Don’t Miss: How Old Do You Need To Be For Medicare Coverage
What Do Dermatologists Recommend For Thinning Hair
Heres what a dermatologist might recommend, depending on the cause of your hair loss:
- Topical minoxidil. More commonly known as Rogaine, this topical cream stimulates hair growth when spread over bald patches.
- Prescription medication. Men might be prescribed finasteride, a pill that stops the body from making the dihydrotestosterone that slows down hair loss.
- Corticosteroids. But both men and women can try steroid shots, or corticosteroids. These targeted injections reduce inflammation in the body, allowing hair to grow more easily.
- Hair transplants. This procedure is essentially a skin swap the surgeon takes a piece with good hair growth and moves it to a bald patch. The idea is that the transplanted piece will assimilate into the new area.
- Scalp reduction or expansion. Both these procedures are meant to stretch areas with fruitful growth to cover areas with poor hair growth.
Where Can I Get More Information
If you want more information about wigs and head coverings, including where to purchase them and the benefits they may have for cancer patients, call the American Cancer Society’s Cancer Helpline at 227-2345 or reach out to an organization that specializes in your specific type of cancer.
Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles heâs written, helping Americans better understand their health insurance and Medicare coverage.
Christianâs work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.
While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.
Christianâs passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.
Don’t Miss: Does Medicare Cover Stair Chairs
The Steps You Should Take
Contact the benefits department for your health insurance and ask:
- Does your policy cover a cranial prosthesis?
- If it does, what type of prosthesis is covered
- How much of the cost do they cover?
- What specific terminology for a wig should the prescription contain?
- Is there required documentation they need to submit your claim? What is it?
Note: When reviewing your insurance policy and you dont see cranial prosthesis listed, it doesnt necessarily mean you dont have coverage. We strongly recommend that you call your health insurance company and get pre-authorization.
NEXT:
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.
Don’t Miss: What Documents Do I Need To File For Medicare
Timing Your Wig Purchase
It is a good idea to purchase your wig before your cancer treatments begin. Not only does this make it easier to find a wig that better matches your current hair color and style, but it also allows you to be better prepared for hair loss once it happens.
You may want to talk with your doctor before you make your purchase. If there is a high probability that you will lose your hair, ask your oncologist to write a prescription for a cranial prosthesis rather than a wig to claim insurance benefits. Wigs needed for medical purposes are often partially or fully covered by health insurance.
After you make your purchase, you may want to make an appointment with your hairstylist. Some patients choose to get themselves ready by cutting their hair short. Some patients also choose to have their wigs trimmed and styled for their faces.
