California Bill Would Mandate Insurance Companies Pay for Wigs for People With Hair Loss

(The Mercury News/TNS) — Hair loss is something Mihir Sharma from Saratoga, Calif., who has alopecia areata, has been dealing with for most of his life.

The articulate and confident 17-year-old has grown accustomed to stares or strange looks from his classmates when they see the lack of hair on his head.

Sharma is one of at least 80 million people across the United States who suffer from hair loss due to various medical conditions such as alopecia areata, lupus and cancer patients receiving chemotherapy treatment. A new proposal by California Assemblymember Marc Berman, a Menlo Park Democrat, would help many in California cover part of the cost of a wig or hairpiece, which can often go for thousands of dollars, by requiring insurance companies to pick up $750 of the tab. 

Berman introduced Assembly Bill 2668 last month and it is expected to be taken up by the health committee in April.

For young people affected by hair loss, the condition can be tough to deal with, especially in environments where teasing may be prevalent.

Sharma, who was diagnosed with alopecia areata — an autoimmune disease that attacks hair follicles — when he was 3, said beyond beauty, a wig for him is about blending in with his peers.

“The wig provides a sense of security because, with alopecia, you can’t prevent those stares,” said the high school student who was one of the young people who inspired Berman’s bill, along with Mountain View High School student Miranda Huang. “People don’t necessarily mean it negatively; it’s just different, it could be curiosity or surprise. Wearing the wig helps you blend in and maintain that sense of security.”

Sharma was fortunate enough to afford a wig.

But not everyone who experiences hair loss can afford them, especially if insurance companies decline to help pay for them, which is not uncommon in California.

Berman’s office pegs the average cost of a wig at $1,500. But according to some patients The Mercury News spoke with, wigs can cost from $500 for synthetic hair to $3,000 or more for a higher-end custom wig made from human hair.

“I didn’t realize how expensive even medium-quality wigs are,” Berman said.

“[The cost] is an extraordinary amount of money,” Berman said. “These are hairpieces that people are going to wear every day that become a part of them and their identity.”

At least six states mandate insurance coverage for wigs. New Hampshire stipulates coverage specifically for alopecia areata, while Connecticut, Maryland, Massachusetts, Oklahoma and Rhode Island provide coverage for individuals with cancer.

Getting the bill passed in California won’t be an easy task, however.

The California Association of Health Plans has not yet taken a position on the proposal, but said it would likely oppose it due to the increased costs covering wigs and hairpieces would entail.

“We have not yet taken a position on AB 2668, but since it is a benefit mandate, we will likely oppose it,” said Mary Ellen Grant, a spokesperson for the group.

Berman said that while he is aware of insurance providers’ concerns regarding costs, he emphasized that “those suffering from medically induced hair loss are far more valuable than the potential costs associated with mental health struggles.”

Dr. James Pathoulas, Department of Dermatology resident at Stanford Medicine, said that wigs and hairpieces should be covered because hair loss is more than a cosmetic concern, impacting quality of life, and that studies show that people with persistent severe alopecia areata can suffer depression and find it difficult to find a spouse or succeed in the workplace due to their hair loss.

“I think wigs serve a similar purpose to other currently covered durable medical equipment that helps people live a full life, like canes and walkers,” Pathoulas said.

Lynn Fisher, 65, of San Jose received a wig from the local nonprofit Cancer CAREpoint over seven years ago, shortly after she was diagnosed with cancer.

She said it added “normalcy” to her day and helped her maintain her self-confidence as she received chemotherapy.

“I wanted to continue my life without having attention drawn to the fact that I had cancer,” Fisher said. “And it just allowed me to do that.”

Cancer CAREpoint deputy director Morrigan Bruce echoed Fisher, saying, “This bill underscores what we’ve always said: Wigs are not vanity. They are an essential component of allowing a patient to reclaim their identity and to see themselves again.”

Adrianna Zhang, a sophomore at Stanford University, began experiencing hair loss at the age of 10 due to alopecia areata.

Zhang wore wigs before receiving medical treatment for hair loss. “I used to believe that every time I walked out, people would be staring,” she said. “In reality, the mental impact of it is much greater in your head – things always get better as you grow up.”

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