Insurance Reimbursement content
Use your medical insurance to pay for your wigs and toppers.
Did you know that many insurance companies will pay towards your human hair wig or topper purchase?
Depending on your policy, most insurance companies cover between 50 to 100% of a cranial prosthesis, if you are wearing a wig for medical reasons and experiencing medical hair loss.
Read our Insurance Reimbursement info. to see how you may be eligible to be reimbursed on your next human hair wig or Topper by going through your insurance.
NOTE: Remember you will need a prescription from your physician with the diagnostic code written on the prescription to accompany your product receipt.
Here are Confirmed Insurance Companies who are offering Cranial Prosthetic (wig) Benefits:
- Aetna
- Blue Shield
- United Healthcare
- Humana
- TriCare
- Anthem
Step-by-Step Guide to Receiving Insurance Reimbursement for a Wig from OA Salons
Here’s a step-by-step guide to help you advocate for the coverage you deserve as you navigate the reimbursement process.
Step 1: Think like a health insurance provider
For many years, most health insurers classified wigs as cosmetic items and therefore did not consider them medically necessary. To improve the chances of coverage, it’s important to communicate using the terminology insurers recognize. When speaking with your physician or insurance provider, always refer to a wig as a “cranial prosthesis” (medical wig), not simply a “wig.” Insurers may consider wigs as “cosmetic,” which are not covered.
Step 2: Understand your policy.
Before purchasing a cranial prosthesis, contact your insurance company to confirm whether your policy provides coverage. When speaking with them, explain that you have alopecia areata, a chronic autoimmune condition. Because many policies do not explicitly list coverage for cranial prostheses in their written materials or online, calling directly is the most reliable way to get accurate information. If you receive health insurance through your employer, your Human Resources Benefits Manager may also be able to help.
You’ll want to ask:
- Do I have coverage for a cranial prosthesis?
- How many cranial prostheses can I receive reimbursement for each year? (Some companies may reimburse for more than one per year.)
- What is the most that insurance will reimburse for each cranial prosthesis?
- What is the specific process to submit a claim for reimbursement?
Step 3: Get a diagnosis and a prescription.
To qualify for reimbursement, you’ll need documentation from your healthcare provider. Schedule an appointment with your dermatologist or specialist, who can confirm your alopecia areata diagnosis and provide a letter (or prescription) stating your condition and the recommended treatment: a cranial prosthesis.
The letter or prescription should also include:
Diagnosis code – a medical code for alopecia areata (or its specific type). Your health provider should include this in your prescription.
HCPCS codes
- A9282: Wig, any type
- S8095: Cranial Prosthesis for medically induced or congenital hair loss
Step 4: Work with OA Salons to purchase your wig:
OA Salons will provide a medical invoice, which you will need for your claim.
Your cranial prosthesis receipt (or invoice) from OA Salons will include:
- The product you are purchasing, listed as a “Cranial Prosthesis,” not a “wig.” Including the price and any customization fees.
- OA Salons Tax ID #
- OA Salons NPI code
Step 5: Submit your claim.
First, make sure you have all the required paperwork ready before submitting your claim. This typically includes:
1. Diagnosis Letter: A letter or prescription from your healthcare provider confirming your diagnosis and medical need for a cranial prosthesis.
2. Receipts: Save all receipts and invoices associated with your wig purchase.
3. Insurance Claim Form: Obtain and complete the claim form provided by your insurance company.
4. Additional Documentation: Some insurers may request extra materials, such as before-and-after photos of your hair loss.
Once you’ve gathered all your documentation:
- Contact Your Insurer: Before submitting anything, call your insurance provider to confirm the required documents and clarify any questions.
- Submit Your Claim: Send your claim form and all supporting documents using your insurer’s preferred submission method—such as their online portal, email, or mail.
- Follow Up: Reach out to your insurer two to three weeks after submitting your claim to confirm they received it and that everything needed was included.
- Track Everything: Keep a detailed log of all interactions with your insurance provider. Note the date, communication method, representative’s name, reference numbers, any additional documents sent (and how they were sent), and other relevant details. Use this log as a reference during future conversations and continue following up until your claim is approved or denied.
Navigating wig reimbursement can be challenging, but with thorough documentation, consistent follow-ups, and timely appeals, you can improve your chances of getting the support you deserve.
