Bill Text: NY A02683 | 2025-2026 | General Assembly | Introduced
Bill Title: Provides coverage for a cranial prosthesis under certain conditions; defines a cranial prosthesis as a wig or hairpiece.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced) 2025-01-22 - referred to insurance [A02683 Detail]
Download: New_York-2025-A02683-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 2683 2025-2026 Regular Sessions IN ASSEMBLY January 22, 2025 ___________ Introduced by M. of A. BORES -- read once and referred to the Committee on Insurance AN ACT to amend the social services law and the insurance law, in relation to coverage for a cranial prosthesis The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. This act shall be known and may be cited as the "wig insur- 2 ance guarantee (W.I.G) act". 3 § 2. Subdivision 2 of section 365-a of the social services law is 4 amended by adding a new paragraph (nn) to read as follows: 5 (nn) (i) cranial prosthesis for individuals experiencing permanent or 6 temporary medical hair loss when: 7 (1) prescribed by a licensed provider for the course of treatment for 8 a diagnosed health condition, chronic illness, or injury, including, but 9 not limited to, alopecia areata, alopecia medicamentosa, scarring alope- 10 cia, and lupus; 11 (2) the policy provides coverage for a cranial prosthesis to a recipi- 12 ent no more frequently than once every twelve months; and 13 (3) the coverage is limited to seven hundred fifty dollars for each 14 instance of coverage, and shall be subject to any cost-sharing require- 15 ments that are otherwise applicable. 16 (ii) For the purposes of this paragraph, the term "cranial prosthesis" 17 means a wig or hairpiece. 18 § 3. Subsection (i) of section 3216 of the insurance law is amended by 19 adding a new paragraph 40 to read as follows: 20 (40) (A) Every policy which provides coverage for prostheses shall 21 provide coverage for cranial prostheses for individuals experiencing 22 permanent or temporary medical hair loss provided: 23 (i) a licensed provider prescribes such cranial prosthesis for a 24 covered person's course of treatment for the diagnosed health condition, EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD04171-01-5A. 2683 2 1 chronic illness, or injury, including, but not limited to, alopecia 2 areata, alopecia medicamentosa, scarring alopecia, and lupus; 3 (ii) the policy provides coverage for a cranial prosthesis to a 4 covered person no more frequently than once every twelve months; and 5 (iii) the coverage is limited to seven hundred fifty dollars for each 6 instance of coverage, and shall be subject to any cost-sharing require- 7 ments that are otherwise applicable. 8 (B) For purposes of this paragraph, the term "cranial prosthesis" 9 means a wig or hairpiece. 10 § 4. Subsection (l) of section 3221 of the insurance law is amended by 11 adding a new paragraph 23 to read as follows: 12 (23) (A) Every group or blanket policy delivered or issued for deliv- 13 ery in this state that provides coverage for protheses shall provide 14 coverage for cranial prostheses for individuals experiencing permanent 15 or temporary medical hair loss provided: 16 (i) a licensed provider prescribes the cranial prosthesis for an 17 enrollee's course of treatment for the diagnosed health condition, 18 chronic illness, or injury, including, but not limited to, alopecia 19 areata, alopecia medicamentosa, scarring alopecia, and lupus; 20 (ii) the policy provides coverage for a cranial prosthesis to an indi- 21 vidual enrollee no more frequently than once every twelve months; and 22 (iii) the coverage is limited to seven hundred fifty dollars for each 23 instance of coverage, and shall be subject to any cost-sharing require- 24 ments that are otherwise applicable. 25 (B) For purposes of this paragraph, the term "cranial prosthesis" 26 means a wig or hairpiece. 27 § 5. Section 4303 of the insurance law is amended by adding a new 28 subsection (ww) to read as follows: 29 (ww)(1) A hospital service corporation, health service corporation or 30 medical expense indemnity fund which provides coverage for prostheses 31 shall provide coverage for cranial prostheses for individuals experienc- 32 ing permanent or temporary medical hair loss provided: 33 (A) a licensed provider prescribes the cranial prosthesis for an 34 enrollee's or subscriber's course of treatment for the diagnosed health 35 condition, chronic illness, or injury, including, but not limited to, 36 alopecia areata, alopecia medicamentosa, scarring alopecia, and lupus; 37 (B) the contract provides coverage for a cranial prosthesis to an 38 individual enrollee or subscriber no more frequently than once every 39 twelve months; and 40 (C) the coverage is limited to seven hundred fifty dollars for each 41 instance of coverage, and shall be subject to any cost-sharing require- 42 ments that are otherwise applicable. 43 (2) For the purposes of this subsection, the term "cranial prosthesis" 44 means a wig or hairpiece. 45 § 6. This act shall take effect immediately and shall apply to any 46 policy issued, delivered, renewed, and/or modified on or after such 47 effective date.
