Livs Wigs; The Cranial Prosthesis Specialist

 

Greetings from Livs Wigs LLC! Here is where you can learn more about Cranial Prosthesis Medical Grade Units and how it may be covered by your Medical Insurance Coverage. If you are in need of a replacement unit but want to use your medical insurance, please feel free to keep reading!

What is a Cranial Prosthetic?

Of course, we have cosmetic wigs, which are more delicate and are not covered by your medical insurance. Medical grade units, also known as cranial prosthetics, are hair pieces that are made to be more durable for everyday use. Medical grade units are constructed with medical grade material for durability. There are scalp features, stronger lace, and sturdier elastic for a stable hold. Medical grade units aren’t just made for the entire head, there are several hair pieces that are considered medical grade units, and they are meant to cover patterns of hair loss due to medical illness, trauma, and/or side effects to medication. It’s because of this necessity why your medical insurance may cover the costs of your replacement unit.

So how can you apply for a medical grade unit, and have it covered by your insurance? 

Well, first we advise that you call your insurance company and see if it’s covered. When calling, be sure to mention “medical grade unit”. Your insurance company may cover full or partial costs of your medical grade unit. When you connect with your insurance company it may be helpful for you to include some detailed information such as letting them know you have hair loss due to chemotherapy, alopecia, alopecia areata, trichotillomania, and other conditions resulting in hair loss.

It’s important to know the terminology when applying for medical insurance. Other common terms you may use to describe a medical grade unit are cranial hair prosthesis, hair prosthesis, and full cranial prosthesis.

It’s also important to know that coverage of your medical grade unit depends on your plan. Best case scenario, if your medical grade unit is covered under your plan, it’s possible that your insurance may cover the cost upfront without there being an out-of-pocket cost for you, or they may require you to pay for your unit first, while they reimburse you later. Many insurance companies cover 80-100% of the cost for your medical grade unit. One cranial prosthetic unit is allowed per year for medical hair loss (which isn’t a bad thing, most units last for up to a year or longer if properly cared for. Plus, you may grow tired of your unit and there’s nothing wrong with a change – remember, mental and emotional well-being is very important. *smile*)

 

A few types of hair loss covered by medical health insurance include:

 

ü  Hair loss due to Chemotherapy treatment

ü  Alopecia

ü  Radiation Related Hair Loss

ü  Heredity

ü  Skin disease

ü  Stress

ü  Burn victim, trauma

Here are some helpful tips on how to receive your medical grade unit, with the possibility of using your health insurance:

Ø  Connect with your benefits department for your health insurance and ask:

ü  Does your policy cover cranial prosthesis?

ü  If so, ask what type of prosthesis is covered such as human hair or synthetic medical grade?

ü  How much of the medical grade unit cost do they cover?

ü  What specific terminology for your hair replacement unit should the prescription contain?

ü  What is the specific required documentation needed to submit your claim?

 

Please note that when you are reviewing your insurance policy if cranial prosthesis isn’t listed, that doesn’t necessarily mean your replacement unit won’t be covered. (Maybe you’ve read so much, and your eyes got blurry, so you didn’t notice, or maybe it was so tiny on your policy you didn’t see it, or perhaps it simply just wasn’t listed). Either way, it is highly recommended that you always call your health insurance and receive pre-authorization.

 

What next?? Well….

 

ü  You can get a prescription for a “cranial prosthesis” from your physician (or a dermatologist). Make sure that’s the correct terminology required by your health insurance provider. Upon consultation with your physician your prescription should include procedure code "A9282". It’s important that the prescription does not say “wig”. Because a "wig" is considered a cosmetic item and not medically necessary, your insurance will think you’re trying to get a pre-plucked with baby hair, full lace fancy unit and deny your claim. The procedure code/number on your cranial prosthesis prescription is used to submit your insurance claim. Remember, medical grade units are made with medical grade materials, they are made to be more durable and are made to match your personal needs and goals. (I totally hope this makes sense)

ü  Have your physician write a letter, your letter will humanize you, as it should. We are human, we have feelings, we want to feel good. You’re not just a claimant. In your letter, it is important that your physician explains your hair loss and the devastating effects it’s had upon you. Your physician may also state that your prosthesis is not for cosmetic reasons, but for your emotional well-being. (which wouldn’t be a lie emotional well-being is very important).

If your health insurance does not cover the cost of your medical grade unit, you can explore other resources such as the National Alopecia Areata Foundation, or the American Cancer Society. It is important to understand their requirements. You may qualify for financial assistance toward your hair replacement. If you pay for your hair replacement out of pocket, be sure to consult with your CPA for information on tax deductibles.

I am happy to report Livs Wigs LLC is now accepting, Aetna Yay!

Here’s what you should know about Aetna…. The reimbursement rate for participating providers of medical grade replacement units (cranial prostheses) diagnosis code A9282 is $1,000. But again, depending on your plan, please call and be sure your medical grade replacement unit is covered.

UPDATE as of November 7th, 2023, Livs Wigs is now a provider of United Health Care, Oxford. Connect with us for details on how to obtain a unit using your insurance! 

For more information or a consultation to speak more about your needs, wants, and goals, please feel free to connect with Liv Early at learly@livswigs.com. Thank you so much for taking the time to read this piece. I do hope you'll connect with us and give us the opportunity to work with you. We will do our very best to meet your needs and for every sale made, a percentage will be donated to the Jed Foundation (to provide support with teen suicide prevention). 

Cheers to having faith, feeling hopeful, and being fabulous!