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Medicare Cranial Prosthesis Process / Coverage

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Wondering if anyone has experience getting a wig aka "cranial prosthesis" through Medicare. My doctor tells me it has been submitted but something is keeping it from getting to Medicare. Any ideas? I keep pestering the doc admin and they keep trying, but not having any luck (since July 22). Odd because they said they can do it. Wig company said they could as well, but they haven't been responsive.

It is my understanding that Medicare should cover it - My Plan N Medigap "said so." ha ha.

Any and all help appreciated! TIA.

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  • maggie15
    maggie15 Member Posts: 852
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    jakeinva, I would ask your doctor's office to check that the information is 100% correct. I ran into a problem with Medicare when the provider's tax ID had two digits reversed. It was quickly fixed by submitting a corrected claim.

  • olma61
    olma61 Member Posts: 1,016
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    In 2017 when I started chemo, Medicare was not covering "cranial prosthesis" for cancer patients but that could have changed. Hopefully, it did.

    MediCAID at that time did cover them (capitals to emphasize the different program)

  • jakeinva
    jakeinva Member Posts: 17
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    ​Thanks Maggie - I will emphasize that - very helpful!
  • jakeinva
    jakeinva Member Posts: 17
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    thanks Olma - Seems like i saw that they did somewhere, but not sure where.