Insurance Coverage and Wigs
For some people with breast cancer, a wig can serve as an escape from the constant reminder of the side effects of chemotherapy and other treatments. But wigs can be expensive.
The good news is that some insurance plans cover some or all of the cost of a wig for cancer-related hair loss. The bad news is that even if the wig is covered by your insurance, you or someone you trust may need to invest some time ensuring that paperwork is filled out correctly and you receive reimbursement for the wig.
Understanding the cost of wigs and ways to bring down these costs can help you pick the best option for you.
How much does a wig cost?
Wigs can range in price from under $30 to over $4,000. These prices vary based on whether a wig is made from synthetic or human hair, the style, and its overall quality. For example, human hair wigs range from $700 to $4,000, according to Wigs.com, while the synthetic styles on CoilstoLocs range from $100 to $135. If you are looking for less expensive wigs, you might want to check out secondhand options online; for example, eBay and Poshmark, Facebook Marketplace, and Instagram all have gently used wigs for sale.
Other costs associated with wigs include a wig stand ($6 to $40), cleaning products ($8 to $54), combs ($5 to $15), and glue or tape ($5 to $35).
Coverage of medical wigs: hit or miss
Depending on the type of health insurance you have, some or all of the cost of what insurers call a “cranial prosthesis” or “hair prosthesis” (names for a medical wig) may be covered by your insurer.
Here’s some general information about coverage for medical wigs by health care insurers:
Private insurance: Insurers and policies vary. Check directly with your insurer.
Medicare: Most Medicare plans, including Part A and Part B, do not cover the cost of a wig for chemotherapy-based hair loss. This is because these plans do not consider medical wigs to be “medically necessary” for treating a specific condition. If you have Medicare Advantage (also called Medicare Part C) plan, contact customer service for more information about your specific coverage.
Tricare: This agency for those in the military and their families will cover the cost of one wig per lifetime when a physician writes a prescription for it based on hair loss due to cancer treatment.
Medicaid: In some states, Medicaid will reimburse for some of the costs associated with a hair prosthesis following chemotherapy or radiation if it has been prescribed by an oncologist.
Questions to ask your insurer
Researching your policy online may help you better understand where to start the conversation with your insurer. For instance, you may find language online about services your insurer won’t cover, such as cosmetic surgery to enhance one’s appearance.
Even if you think you found your answer online, it’s a good idea to call your insurance company directly and ask specific questions. Here are some questions to get you started:
Does my policy cover some or part of the cost of a cranial prosthesis or hair prosthesis? How much?
How does coverage work? (For example, do I pay the full cost of the wig up front and you reimburse or does the insurance bring the cost down at the time of payment?)
Is the coverage the same regardless of whether the medical wig is made of human or synthetic hair?
What paperwork is needed to process my claim? (Often insurance companies require a prescription from your doctor, the receipt for the wig, and a completed insurance claim form.)
What information do you require on a prescription for a medical wig? Is there specific wording or diagnostic or procedural codes that my healthcare team must use?
“[M]ost health insurers require that you submit a prescription from your doctor with the correct wording,” said Dianne Austin, who was diagnosed with breast cancer in 2015 and created the company Coils to Locs in 2019.
Charities and Wig Banks
If your insurance doesn’t cover the cost of a medical wig or only covers a small portion, you may want to check out wig banks and charities that provide free wigs to people with cancer.
Contact your local chapter of the American Cancer Society at 1-800-227-2345, or speak with a social worker or another person on your healthcare team to learn about options near you.
Other organizations that provide wigs to people undergoing cancer treatment include:
Other ways to save on medical wigs
Deduct total medical expenses from your taxes: Your insurance plan will determine whether you need to pay part of the cost of a wig through meeting a deductible, co-payments, or co-insurance. Keep records on how much you spend on medical expenses each year. Medical expenses include the out-of-pocket costs for a wig, along with co-payments, co-insurance, parking fees for appointments, and the amount it costs you to travel to and from medical appointments. If your medical expenses at the end of the year are more than 7.5% of your adjusted gross income, you may be able to deduct these costs from your taxes, according to the Internal Revenue Service. To report your medical deductions, you will need Schedule A (Form 1040). If you are unsure if you meet the level to deduct your medical expenses from your taxes, you may want to talk with a tax advisor.
Consider setting up a flexible spending account or health savings account: If you are employed and receive healthcare through your employer, you may be able to set up a Flexible Spending Account (FSA) or Health Savings Account (HSA) through your employer that could be used to pay for a medical wig, provided you have a medical diagnosis and a letter of medical necessity from your doctor. These plans allow you to set aside money before taxes; while you’re still paying for the wig with your own money, you save by not having to pay taxes on that income.
— Last updated on December 6, 2024 at 7:07 PM