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How To Get My Wig Covered By Insurance for Medical Purposes

If you suffer from Alopecia, Trichotillomania or a cancer patient you may have insurance coverage to offset the cost of your medical wig (Cranial Prothesis). These wigs are not for cosmetic purposes, and they may qualify for 80-100% reimbursement by your insurance company. This document is to help assist you when dealing with your insurance company. Make sure you make copies of everything.

 

When looking over your insurance policy to verify your coverage the information will likely be listed under Durable Medical Equipment. It is best to call your insurance company first and get a pre-authorization and find out what they will cover, and the process required for achieving coverage, including terminology to get the cranial prothesis paid for.

1 - Get a diagnosis from your doctor- You will need to provide a copy

2 - A written prescription from your doctor. Make sure his NPI Code is on it (10-digit number) and the Healthcare Common Procedure Coding Systems (HCPCS) S8095 , A9282 or 99199; Human hair L8499

3 - A letter of necessity- This is important to detail the psychological effect that hair-loss has had on you and include photos

4 - An invoice/receipt from Coastal Wigs will be provided that will include Cranial Prothesis Unit, the HCPCS insurance codes S8095 and A9282 our Tax Id number : 3-20527-0401-5 and our NPI #1154889137

5 - Have your DR sign off on the insurance claim

Common Terms for Medical Wigs:

  • Cranial Prothesis Units
  • Cranial Hair Prothesis Units
  • Extra-Cranial Prothesis

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