Quick answer: One phone call to your insurer before you buy can save weeks of paperwork and prevent an avoidable denial. Call the member services number on your card and ask the seven questions below — then write down the date, the representative's name, and the reference number for the call.
The seven questions
- "Does my plan cover a cranial prosthesis — HCPCS code A9282 — when prescribed by a physician for medical hair loss?" Use those exact words; "wig" can trigger the cosmetic exclusion even on plans that cover prostheses.
- "Do you require a prescription, a Letter of Medical Necessity, or both?" This determines what to ask your doctor for — in one visit instead of two.
- "Is there a coverage limit or a frequency limit?" Some plans cap the dollar amount or cover one prosthesis per year or per diagnosis.
- "May I purchase from any supplier and submit for reimbursement, or must I use an in-network supplier?" Most personal claims are purchase-and-submit, but confirm.
- "Which claim form do I use, and how do I submit it?" Ask whether online submission is available and what attachments are required.
- "Is prior authorization required?" Rare for prostheses, but a denial for missing prior auth is entirely preventable.
- "How long does processing take, and how will I be notified?" Sets expectations and tells you when to follow up.
Write it all down. Date, representative's name, reference number, and their answers. If a claim is later denied in contradiction to what you were told, that call record strengthens your appeal considerably.
Then, the paperwork is easy
With answers in hand: get the prescription (and LMN if required), purchase your prosthesis — every ANIOR Medical piece ships with the complete documentation packet — and submit. The complete guide →
Reviewed by the ANIOR Medical team · Updated July 2026. General information, not benefits advice. Coverage is determined solely by your insurer.