Does Medicare Cover Wigs for Cancer Patients?
Navigate Medicare's rules on wig coverage for cancer-related hair loss and discover other financial assistance options.
Medicare is a federal health insurance program for those aged 65 or older and younger individuals with certain disabilities. It is structured into different parts, each covering specific health services. Understanding Medicare’s coverage, especially for items like wigs, can be complex.
Medicare and Wig Coverage
Original Medicare, comprising Part A (Hospital Insurance) and Part B (Medical Insurance), generally does not cover wigs for cancer patients. This is because wigs are typically classified as cosmetic items rather than durable medical equipment (DME) or prosthetic devices. Examples of covered DME include wheelchairs, hospital beds, and oxygen equipment.
Medicare Part B does cover prosthetic devices that replace a body part or function, such as breast prostheses after a mastectomy and artificial limbs. However, even when referred to as “cranial prostheses” and prescribed by a doctor, Original Medicare considers wigs aesthetic items, not covered prosthetic devices or DME, even for hair loss due to chemotherapy or a medical condition.
Other Potential Payment Options
Since Original Medicare does not cover wigs, individuals may need to explore alternative payment options. Medicare Advantage plans (Part C), offered by private insurance companies approved by Medicare, are required to cover at least the same services as Original Medicare. Many of these plans, however, also offer additional benefits that Original Medicare does not, and some may include coverage for wigs, though this varies significantly by plan and location. It is advisable to contact the specific Medicare Advantage plan provider to inquire about their coverage for wigs and any associated benefit limits.
Medigap policies, Medicare Supplement Insurance plans, generally do not cover wigs. They are designed to help pay for out-of-pocket costs for services covered by Original Medicare, not to expand coverage to non-covered items. Private health insurance plans may offer coverage, and individuals should review their policy documents or contact their insurer directly. Additionally, numerous charitable organizations and cancer support groups offer financial assistance or provide free or low-cost wigs to cancer patients. Examples include the American Cancer Society, the Verma Foundation, and others that focus on supporting individuals experiencing cancer-related hair loss.
Wig costs may also be eligible as a medical expense deduction on federal income taxes. To qualify, the wig must be medically necessary and prescribed by a healthcare provider for hair loss due to a medical condition or treatment like chemotherapy. Taxpayers must itemize their deductions on Schedule A (Form 1040) and their total qualified medical expenses must exceed 7.5% of their adjusted gross income. It is important to retain all relevant documentation, such as prescriptions and receipts, to support the deduction.