Are Cranial Prostheses Covered by Insurance or Other Healthcare Plans?

Cranial prostheses can provide an effective non-surgical hair replacement solution for those experiencing hair loss. In this blog post, we will delve into the world of cranial prosthesis coverage and discuss various factors affecting eligibility.

We will explore the benefits of using cranial prostheses as well as common insurance providers offering reimbursement. Additionally, we will share valuable tips on maximizing your chances for reimbursement through obtaining prescriptions from doctors and properly documenting expenses.

Understanding Cranial Prostheses

A cranial prosthesis is a non-surgical hair replacement solution designed for individuals experiencing hair loss due to medical conditions such as cancer treatment or alopecia. These prosthetics can help patients cope with their treatment and recovery process, by providing a sense of normalcy and confidence during this challenging time.

Non-surgical Hair Replacement Options

  • Cranial Prostheses: Custom-made hair prosthetics that closely resemble the patient’s natural hair, offering comfort and style.
  • Hair Toppers: Smaller pieces that cover only specific areas of thinning or balding, ideal for those with partial hair loss.
  • Hair Extensions: Add length and volume to existing hair, suitable for those who still have some healthy strands remaining.


Benefits of Using Cranial Prostheses

  1. Promotes Self-Esteem: Helps restore appearance while undergoing treatments that cause temporary or permanent hair loss.
  2. Eases Emotional Stress: Reduces anxiety related to changes in physical appearance caused by medical treatments like chemotherapy or radiation therapy.


Whether cranial prostheses are covered by medical insurance is a common question among patients considering this option. The answer is it depends on the individual’s insurance coverage and the specific plan they have. Some insurance plans do cover cranial prostheses, while others may not. It is important to check with your insurance provider to determine if this type of hair replacement solution is covered under your plan.

At Hair Center of Palm Beach, we understand the importance of feeling confident and comfortable during your treatment and recovery process. Our team of experts can help you find the right non-surgical hair replacement solution for your needs. Contact us today to schedule a consultation.

Cranial prostheses offer a non-surgical hair replacement option that can help restore confidence and empower those suffering from hair loss. Figuring out what insurance covers when it comes to cranial prostheses is essential for getting the best treatment possible.

Insurance Coverage for Cranial Prostheses

Whether your health insurance covers the cost of a cranial prosthesis depends on your specific plan. Some providers like Blue Cross Blue Shield, Aetna, Tricare, and Medicare Advantage plans may reimburse you for hair replacement solutions if they are specifically outlined in the plan’s list of benefits; however, Original Medicare does not cover these costs.

Man at barbershop

Factors Affecting Coverage Eligibility

  • Your Medical Condition: Insurances typically covers hair replacement only when hair loss is due to a medical illness or treatment.
  • The Type of Hair Prosthesis: Insurance companies might require that the cranial prosthesis be classified as durable medical equipment (DME).
  • Your Policy Details: Review your insurance policy or contact your provider to confirm whether cranial prostheses are covered.

Common Insurance Providers Offering Hair Prosthetic Reimbursement

Other insurance providers that may cover cranial prostheses include Cigna, UnitedHealthcare, and Humana. It is essential to check with your specific health insurance provider regarding their policies on covering this expense.

With the right information and preparation, individuals can maximize their chances of receiving reimbursement for cranial prostheses. To that end, it is important to understand how insurance coverage works, as well as common methods for obtaining prescription from doctors and documenting expenses properly.

Maximizing Chances for Reimbursement

To increase the likelihood of getting coverage for your cranial prosthesis, it is essential to follow a few key steps. By obtaining a prescription from your doctor and keeping all invoices and documentation related to its purchase, you can ensure that you have everything needed if reimbursement is an option.

Obtaining Prescriptions from Doctors

Your healthcare provider plays a crucial role in helping you secure insurance coverage for your cranial prosthesis. Requesting a prescription specifically stating “cranial prosthesis” instead of just “wig” can make all the difference when submitting claims or tax deductions.

Documenting Expenses Properly

  • Maintain copies of receipts, invoices, and any other relevant paperwork associated with purchasing your cranial prosthesis.
  • Create a dedicated file where you store these documents along with records of other medical expenses related to your treatment journey.
  • If insurance does not cover the cost, remember that you may be able to deduct this expense as a medical expense on your taxes by following proper guidelines provided by the Internal Revenue Service (IRS).

Securing adequate reimbursement for the hair replacement procedure is essential to ensure that you can access the care needed. Preparing yourself emotionally and physically before undergoing a cranial prosthesis procedure is equally essential; understanding what steps may be necessary prior to treatment will allow for a smoother transition into your new look.

Preparing Yourself Emotionally & Physically

Undergoing cancer treatment can be an emotionally challenging experience, and hair loss is often a significant concern for patients. The American Cancer Society suggests that you might feel more comfortable shaving your head before full hair loss occurs. This approach helps to avoid unpleasant experiences associated with shedding strands during daily activities while also preparing yourself emotionally for upcoming changes in appearance.

Shaving Head Prior to Complete Hair Loss

  • Gives you control over the process of losing hair.
  • Makes it easier to transition into wearing a cranial prosthesis or wig.
  • Avoids the distress of seeing clumps of hair falling out unexpectedly.

Coping Mechanisms During Chemotherapy or Radiation Therapy

To help manage emotions during this time, consider seeking support from friends, family members, and professional counselors who specialize in coping strategies for cancer patients. Additionally, joining online forums or local support groups where others share their experiences can provide valuable insights and encouragement throughout your journey.

Before having a cranial prosthesis procedure, it is essential to be ready mentally and physically to manage the shift more effectively. Choosing the right prosthetic for you should be your next step in achieving a natural-looking hair replacement solution that fits within your budget.


Choosing The Right Hair Replacement Solution For You

Selecting a hair prosthesis that fits your individual needs can be an intimidating process, yet with some advice and considering what you prefer, it is possible to find the ideal cranial prosthesis. Keep in mind these factors when selecting a hair replacement solution:

  • Natural Appearance: Take photographs of how you wear your hair naturally to help select a similar shape and style.
  • Comfort: Look for hair prosthetics with an adjustable band to keep your skin cooler while worn.
  • Budget-Friendly Options: If your insurance provider doesn’t offer coverage for cranial prostheses, shop around for inexpensive alternatives to lessen the financial burden associated with procuring a prosthetic piece. Check out organizations like the American Cancer Society’s TLC program, which offers affordable hair replacement specifically designed for cancer patients.


In addition to considering these factors, consult with professionals at reputable hair replacement centers like The Hair Center of Palm Beach. Our expertise will guide you through the process of choosing and fitting the right cranial prosthesis, tailored to suit both your aesthetic desires and comfort needs during this challenging time.

Picking the ideal hair prosthetic for you can be a tricky endeavor, yet by considering elements like your way of life and monthly expenses, you can discover an economical arrangement that suits both your necessities and style. Working with hospital social workers is also important to manage costs associated with cranial prostheses; they are knowledgeable about organizing medical expense documentation and helping patients secure coverage from insurance or other healthcare plans.

Working with Hospital Social Workers

In addition to working with insurance providers, hospital social workers may have helpful tips on managing cancer-related costs such as cranial prostheses. Hospital social workers are equipped to aid patients in understanding the intricate healthcare landscape, and can furnish helpful information on financial assistance options, communal resources, and support networks.

Role of Hospital Social Workers in Cost Management

  • Assessing your financial needs and identifying appropriate resources.
  • Educating you about available options for coverage or discounts.
  • Helping you apply for financial aid programs or grants if eligible.
  • Connecting you with local organizations that offer free or low-cost wigs.


Organizing Medical Expense Documentation

To ensure a smooth reimbursement process, make copies of all paperwork related to your hair replacement purchase and maintain a file containing records of all medical expenses associated with your treatment journey. This will not only help streamline any potential claims but also allow you to keep track of out-of-pocket costs for tax purposes. Remember that proper organization is key when dealing with insurance companies and other healthcare entities.


FAQs: Are Cranial Prostheses Covered by Insurance or Other Healthcare Plans?

Does Medical Insurance  Cover Cranial Prosthesis?

Medical insurance coverage for cranial prostheses varies depending on the provider and individual policy. Some plans may partially or fully cover the cost if it is deemed medically necessary, such as in cases of hair loss due to chemotherapy or alopecia areata. It’s essential to review your specific plan details and consult with your insurance company.

Does Medicare Cover the Cost of Cranial Prosthesis?

Medicare does not typically provide coverage for a cranial prosthesis unless it is considered durable medical equipment (DME) prescribed by a doctor. However, some Medicare Advantage Plans might offer additional benefits that include hair prosthetic reimbursement. It’s crucial to check with your specific plan provider for more information. Some supplemental policies like Medigap, which work alongside Original Medicare, could potentially offer wig reimbursements depending on their terms and conditions.

Does Aetna Cover Cranial Prosthesis?

Aetna may provide coverage for a cranial prosthesis under certain circumstances, such as when required due to hair loss from chemotherapy or radiation therapy treatments. Coverage depends on the specifics of each individual policy; therefore, it is important to contact Aetna directly and discuss eligibility requirements based on your situation.


Cranial prostheses are a viable non-surgical hair replacement option for those experiencing hair loss. While insurance coverage varies depending on factors such as the provider and reason for hair loss, there are ways to maximize chances of reimbursement – through proper documentation and obtaining prescriptions from doctors. It’s important to prepare yourself emotionally and physically before undergoing treatment that may result in complete hair loss.

When selecting a hair prosthetic or alternative solution, it’s crucial to consider factors such as comfort, style, and affordability. Working with hospital social workers can also aid in cost management and organizing medical expense documentation.

If you’re considering cranial prostheses or other non-surgical options for hair replacement due to medical reasons, contact Hair Center of Palm Beaches today to learn more about our services and how we can help you achieve your desired look.

Let us help you with payment for you cranial prosthesis!