Sponsor
Richard Blumenthal
Senator · D-CT
The bill expands Medicare coverage for cranial prostheses—reducing patient costs and improving care for those with medically necessary hair loss—while increasing program spending and leaving access dependent on clinician certification, which could delay or limit benefits.
Medicare beneficiaries with medically necessary hair loss (e.g., chemotherapy, autoimmune conditions) gain coverage for cranial prostheses when a qualifying clinician certifies need, improving access to medically indicated rehabilitative head coverings and supporting patient dignity and mental health.
Medicare will pay for rehabilitative head coverings prescribed by hospitals and clinicians, reducing out‑of‑pocket costs for patients and simplifying billing for hospitals and health systems.
Taxpayers and the Medicare program may face increased spending to cover cranial prostheses, raising program costs and potential fiscal pressure on Medicare.
Medicare beneficiaries could experience delays or denials of coverage if a qualifying clinician does not provide the required written certification, limiting timely access despite medical need.
Based on analysis of 2 sections of legislative text.
Adds cranial prostheses (wigs) to Medicare durable medical equipment when a qualified clinician certifies medical necessity; denies payment without that certification.
Senator · D-CT
Official title: Amend title XVIII of the Social Security Act to provide coverage for wigs as durable medical equipment under the Medicare program, and for other purposes.
Introduced February 12, 2026 by Richard Blumenthal · Last progress February 12, 2026
Adds cranial prostheses (wigs) to Medicare's definition of durable medical equipment when a dermatologist, oncologist, or the attending physician certifies the item is medically necessary for rehabilitative treatment or hair loss caused by a health condition (including autoimmune disease, cancer, or chemotherapy). The bill also updates Medicare's exclusions to deny payment for cranial prostheses that are not supported by the required medical certification.