Insurance & Documentation Guide

Prepare before contacting your insurer

Some health plans may provide benefits for a cranial prosthesis when hair loss is connected to a qualifying medical condition. Coverage is never automatic, and requirements vary by plan, employer, state, diagnosis, provider network, and documentation.

Questions to ask your insurer

• Does my plan include benefits for a cranial prosthesis or hair prosthesis?
• Which benefit category, billing code, or durable medical equipment provision applies?
• Is a prescription or letter of medical necessity required?
• Must the ordering provider or supplier be in network?
• Is prior authorization required before purchase?
• What is my deductible, coinsurance, annual limit, or replacement schedule?
• Which itemized documents are needed for a claim?
• Where and how should the claim be submitted?

Documents commonly requested

• Prescription using the terminology required by your plan
• Medical diagnosis or letter of medical necessity
• Itemized invoice and proof of payment
• Supplier information requested by the plan
• Prior-authorization approval, when required
• Claim or reimbursement form

Important: Jay Raw Co. can help you organize questions and available purchase documents, but we cannot promise approval, reimbursement, or a specific coverage percentage. Always obtain plan-specific instructions directly from your insurer before ordering.