Is a Cranial Prosthesis Covered by Insurance?

Often, yes. A cranial prosthesis is a medical device prescribed for hair loss caused by a medical condition — and unlike a fashion wig, it’s a covered benefit under many health plans, including most private insurance, Tricare, and some Medicare Advantage plans.

Here’s how we make it work for you:

• We verify before you buy. We help you call your insurer and find out exactly what your plan covers before you spend a dollar.
• The prescription matters. Your physician writes a prescription for a “cranial hair prosthesis” — not a “wig.” Insurance companies exclude wigs as cosmetic; cranial prostheses for medical hair loss are a different category.
• We handle the paperwork. You’ll receive a Letter of Medical Necessity template for your doctor and an itemized superbill with our NPI and Tax ID for your claim.
• HSA & FSA accepted. Health Spending Accounts and Flexible Spending Accounts can be used toward your cranial prosthesis.

Coverage varies by plan — some cover a set amount, some a percentage, some require prior authorization. We’ll make sure you know before you commit.

Am I a Candidate for Insurance Coverage?

If your hair loss is caused by a medical condition, you may qualify. Common qualifying diagnoses we work with:

• Scarring (cicatricial) alopecias — lichen planopilaris, frontal fibrosing alopecia, central centrifugal cicatricial alopecia (CCCA), folliculitis decalvans
• Alopecia areata, totalis, and universalis
• Chemotherapy- and radiation-related hair loss
• Medication-induced hair loss and telogen effluvium
• Lupus, thyroid disorders, and other autoimmune conditions
• Trichotillomania
• Burn and traumatic scarring of the scalp