Insurance Companies That Pay for Cranial Prosthesis Wigs or Alopecia (2025) | Prarvi

1. Why insurers treat medical wigs differently from fashion wigs

Medical terminology matters. Always use “cranial prosthesis” (HCPCS code A9282) on prescriptions and invoices—never just “wig.” (aapc.com, sheitels.com)

Plans normally cover one device per year – lifetime, with a dollar cap ($300 – $1,500) and a doctor’s prescription describing medical necessity.

Medicare still classifies A9282 as non-covered, but a bipartisan bill to change that (HR-2928) is pending. (hcpcsdata.com)

2. 2025 snapshot — how the main U.S. carriers handle cranial prostheses

Carrier	Typical coverage language*	Allowance / limit	Key proof
Aetna	“Cranial prosthesis for hair loss due to disease or its treatment is covered under DME.” (trscare.org, cranialprosthesis.net)	Up to $1,000 once every 12 mos (plan-dependent)	Rx + itemised invoice with A9282
Blue Cross Blue Shield (state plans)	Many state affiliates (VT, RI, NC, MI…) cover one wig after chemo/alopecia. Example VT policy 1.03.VT204. (bluecrossvt.org, bluecrossvt.org)	$350 – $750, 1 per calendar year/lifetime	Rx + HCPCS A9282/S8095
UnitedHealthcare / Oxford	“One wig per member per lifetime for severe hair loss incl. alopecia, burns, chemo, radiation.” (uhcprovider.com)	1 device, amount varies by plan	Letter of medical necessity (LMN)
Cigna	Lists wigs under prosthetic devices; coverage “varies across plans—check SPD.” (static.cigna.com, trscare.org)	$350 – $1,200 common	Rx + LMN
Kaiser Permanente	Covered if prescribed & hair loss from chemo, radiation or cancer treatment. (healthy.kaiserpermanente.org)	One prosthesis per benefit period; cap set by region	Rx + invoice
Oscar	Individual & group plans include cranial prosthesis in essential benefits. (wigs.com)	$500 typical	Rx + invoice
TRICARE (military)	Allows one wig per episode of hair loss (HCPCS A9282). (manuals.health.mil)	Pays billed charge up to regional cap	Rx + DD Form 2642
Medicaid	State-by-state: NY, NJ, MA, CA often cover 1/yr; others require prior auth. Check state DME list.
Medicare (Part B)	Not yet covered; claim will be denied unless new legislation passes. (hcpcsdata.com)

*Always verify your specific Summary Plan Description (SPD); dollar caps and frequency limits vary widely—even inside the same carrier.

3. Insurers that usually exclude or limit coverage

Carrier	Current stance
Humana	Group plans list wigs as “Not covered—cosmetic.” (wigs.com)
Molina, Baylor Scott & White	Individual policies exclude A9282 unless state mandate overrides. (wigs.com)
Some high-deductible employer plans	Wig benefit stripped to lower premiums—file an appeal with LMN.

4. Paperwork checklist (increase approval odds)

Doctor’s prescription that says “Cranial Prosthesis (A9282) medically necessary for [ICD-10 code]” e.g., L63.9 Alopecia areata.

Letter of Medical Necessity (LMN) describing physical & psychosocial impact.

Itemised invoice from Prarvi showing: CPT/HCPCS A9282, NPI, Tax ID.

Pre-authorisation (optional but speeds payment).

Submit claim within your plan’s filing window (often 90–180 days).

Denied? File an appeal with supporting notes from your oncologist/dermatologist plus any state wig-mandate statute.

5. Tax & spending-account perks

Wig listed as A9282 qualifies for FSA/HSA spending.

If total medical expenses > 7.5 % of AGI, the out-of-pocket portion is federal tax-deductible. (healthy.kaiserpermanente.org)

6. How Prarvi helps

Insurance-ready invoices. Every medical-grade unit ships with A9282 coding.

Free coverage consult. Our team reviews your plan and preps draft claim forms on wig purchase.

One-on-one virtual fitting. Book a 20-minute session to confirm size, lace color and cap comfort before purchase.

Explore the Medical Wig collection → prarvihair.com/collections/medical-wigs
Need help? Email preeti@prarvi.com or start a chat—our specialists reply within a business day.

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