"Will my insurance pay for this?" is one of the first questions I hear in a hair loss consultation. The honest answer: sometimes, partly, and it depends on your plan and your diagnosis. I'm Noelle Spinosa, and for 35 years I've helped women with hair loss at Noelle Salon in Melrose, just north of Boston. Here's how coverage usually works and what I do to help.
Quick Answer
- Many insurance plans will reimburse part of the cost of a hair replacement when your doctor prescribes it as a cranial prosthesis for medical hair loss.
- That can include a wig, a hair topper or a mesh integration system, not just a full wig.
- We don't take insurance or bill your insurance company. You pay the salon, and we give you a paid invoice to send in for reimbursement.
- Coverage is never automatic. Call your insurance company before your appointment.
What Is a Cranial Prosthesis?
"Cranial prosthesis" (sometimes "scalp prosthesis" or "medical hair prosthesis") is the term insurance companies use for hair replacement worn because of a medical condition. Most people think it only means a wig. It doesn't. Depending on how much of your own hair you have, it can be:
- A custom hair topper for thinning on top or at the crown
- A mesh integration system that blends with your own hair
- A small fill-in piece for one area
- A full wig for complete or extensive hair loss
She came in sure she needed a wig. A custom solution blended with her own hair instead.
Which Hair Loss May Qualify?
Every plan is different, but these are the conditions most often considered for coverage:
- Hair loss from chemotherapy or radiation
- Alopecia areata, totalis and universalis
- Scarring alopecia
- Other hair loss your doctor documents as medical, such as female pattern hair loss or trichotillomania. These are decided case by case.
Your doctor decides your diagnosis. Your insurance company decides what it will cover.
How to Get Reimbursed: Step by Step
- Call your insurance company first. I give every client instructions for this call. Ask whether your plan covers a "cranial prosthesis," what the yearly limit is, whether it counts toward your deductible, and what paperwork they need.
- Get a prescription from your doctor. It should say "cranial prosthesis" and include your diagnosis.
- Come in for your free consultation and service. We'll recommend the right solution for your hair, whether that's a topper, mesh integration or a wig.
- Pay the salon and get your paid invoice. We write the invoice for a cranial prosthesis, so it matches the language insurance companies use.
- Send in your claim. Submit the prescription and the paid invoice with your insurance company's claim form, and keep copies of everything.
Hair loss after IVF: a custom topper with extensions instead of a wig.
What Coverage Usually Looks Like
Coverage is rarely the full cost. Depending on your plan, insurance might:
- Reimburse part of the cost, up to a yearly limit
- Count the cost toward your deductible
- Cover nothing at all
Many clients are pleasantly surprised to get anything back. Others aren't covered. That's why the phone call comes first.
If Your Claim Is Denied
A denial isn't always the final word. Ask your insurance company why it was denied and what they need. Often it's missing paperwork, or the prescription didn't use the words "cranial prosthesis." Your doctor may be able to write a letter explaining why the prosthesis is medically necessary.
FSA and HSA Accounts
If you have a flexible spending account or health savings account, a cranial prosthesis prescribed for medical hair loss may be an eligible expense. Check with your plan administrator.
What About Hair Extensions?
Hair extensions on their own are usually considered a cosmetic service. But extensions can be part of a custom hair loss solution, for example combined with a topper or mesh integration to add density. Whether that's covered depends on your plan.
Not every prosthesis covers the whole head. This small piece fills in one area.
Not Sure Which Solution You Need?
Most women who come in asking about a cranial prosthesis expect me to recommend a wig. Often the better answer is something smaller that works with the hair you have. Read more in Cranial Prosthesis vs. Wig.
Book a Free Consultation
We'll look at your hair in a private room, talk through the options, and give you the instructions for calling your insurance company. You can also email photos of your hair to noelle@noellesalon.com first.
Book a free hair loss consultation
Frequently Asked Questions
Does insurance cover wigs?
Many plans reimburse part of the cost when a doctor prescribes it as a cranial prosthesis for medical hair loss. Coverage varies, so call your insurance company first.
Does insurance cover hair toppers?
It can. A cranial prosthesis isn't limited to a full wig. Toppers and mesh integration systems can be submitted the same way.
Does Noelle Salon take insurance?
No. We don't bill insurance. You pay the salon, and we give you a paid invoice to submit for reimbursement.
What do I need to submit?
Usually your doctor's prescription for a cranial prosthesis with your diagnosis, our paid invoice, and your insurance company's claim form.
Who can write the prescription?
Usually your primary care doctor, dermatologist or oncologist. Ask your insurance company if they require a specific type of doctor.
