Other Services
Chapter 8
Section 12.1
Wigs Or
Hairpiece
Issue Date: April 19, 1983
Revision:
2.0 POLICY
2.1 The contractor
shall reimburse in accordance with the allowable charge, for one
wig (also known as cranial prosthesis) or hairpiece per beneficiary
(lifetime maximum) when the attending physician certifies that alopecia
has resulted from the treatment of a malignant disease and the beneficiary
certifies that a wig or hairpiece has not been obtained previously
through the United States (US) Government (including the Department
of Veterans Affairs/Veterans Health Administration (DVA/VHA)).
2.2 Allowable
Charge
2.2.1 Effective
January 1, 2011, the contractor shall ensure the allowable charge
does not exceed the Calendar Year (CY) rate specified in
paragraph 2.2.2 per
wig or hairpiece. If the wig or hairpiece purchased by the beneficiary
exceeds this maximum amount, the contractor shall reimburse only
up to the allowable amount. The Government will update this amount
annually by using the Consumer Price Index-Urban (CPI-U). Defense
Health Agency (DHA) will publish the updated amount in this section.
2.2.2 The allowable
charge per wig or hairpiece may not exceed:
• $2,246 for 2018
• $2,295 for 2019
• $2,348 for 2020
• $2,388 for 2021
3.0 EXCLUSIONS
The wig/cranial prosthesis
or hairpiece benefit does not include coverage for the following:
3.1 Alopecia resulting from conditions
other than treatment of malignant disease.
3.2 Maintenance,
supplies, or replacement of the wig/cranial prosthesis or hairpiece.
Statutory provisions limit these items to one furnished at the expense
of the Government (i.e., prosthetic replacement provisions do not apply).
3.3 Hair transplants or any other
surgical procedure involving the attachment of hair or a wig or
hairpiece to the scalp.
3.4 Any diagnostic
or therapeutic method or supply intended to encourage hair regrowth.
- END -