Cranial prosthesis

I am wondering if any of you have been able to get coverage from Medicare for a cranial prosthesis that you have purchased due to hair loss from FFA and LPP.  I am just beginning the journey to try to get Medicare to pay for a prosthesis that I am having made.  The professional who is making this prothesis tells me she doesn't think Medicare will pay for this even though I need this due to a medically induced condition.  I was told to always call our hair coverings cranial prosthesis.  I was also told the medical code is 704.0.  A9282 cpt is another code I was given.  So far, I have not been able to speak to a live person regarding this matter at Medicare.  My supplemental will pay whatever Medicare does not pick up if Medicare will pay.  The prosthesis is costing me $1500.  So far, I have spent nearly $1000 in other hair coverings (wigs).  

I think this is another issue that those of us suffering from this devastating loss should ban together on.  I hope for a cure.  I also home for medical coverage for the prosthesis in the meantime.  What do you all think about this?

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Permalink Reply by Lo on September 30, 2015 at 2:27pm

I agree 100%.  I work for a great company - with decent insurance... however after a long up-hill battle, I landed right where I started - with the answer of "no".  I did find out that our insurance does not cover for hair pieces for cancer patients, either... which I think is such a load of crap.  When the lady at my insurance company told me, "it is not medically necessary - it is cosmetic", I wanted to crawl through the phone and beat her with a wooden spoon.  (I know... calm down, Lori!).  She was probably reading from a script - but who knows.  So... I have paid, like you Sally, up near 1500 - 2000 dollars on different hair pieces/wigs that I couldn't return, etc.  That doesn't included the money I've spent on doctor visits (which are, in part, covered by insurance).  It is an awful thing... for sure.  I think insurance companies should pay partially for eyebrow tattoos, as well.  But I will fight one battle at a time. 

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