S T A T E O F N E W Y O R K
________________________________________________________________________
2683
2025-2026 Regular Sessions
I N A S S E M B L Y
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:
Section 1. This act shall be known and may be cited as the "wig insur-
ance guarantee (W.I.G) act".
§ 2. Subdivision 2 of section 365-a of the social services law is
amended by adding a new paragraph (nn) to read as follows:
(NN) (I) CRANIAL PROSTHESIS FOR INDIVIDUALS EXPERIENCING PERMANENT OR
TEMPORARY MEDICAL HAIR LOSS WHEN:
(1) PRESCRIBED BY A LICENSED PROVIDER FOR THE COURSE OF TREATMENT FOR
A DIAGNOSED HEALTH CONDITION, CHRONIC ILLNESS, OR INJURY, INCLUDING, BUT
NOT LIMITED TO, ALOPECIA AREATA, ALOPECIA MEDICAMENTOSA, SCARRING ALOPE-
CIA, AND LUPUS;
(2) THE POLICY PROVIDES COVERAGE FOR A CRANIAL PROSTHESIS TO A RECIPI-
ENT NO MORE FREQUENTLY THAN ONCE EVERY TWELVE MONTHS; AND
(3) THE COVERAGE IS LIMITED TO SEVEN HUNDRED FIFTY DOLLARS FOR EACH
INSTANCE OF COVERAGE, AND SHALL BE SUBJECT TO ANY COST-SHARING REQUIRE-
MENTS THAT ARE OTHERWISE APPLICABLE.
(II) FOR THE PURPOSES OF THIS PARAGRAPH, THE TERM "CRANIAL PROSTHESIS"
MEANS A WIG OR HAIRPIECE.
§ 3. Subsection (i) of section 3216 of the insurance law is amended by
adding a new paragraph 40 to read as follows:
(40) (A) EVERY POLICY WHICH PROVIDES COVERAGE FOR PROSTHESES SHALL
PROVIDE COVERAGE FOR CRANIAL PROSTHESES FOR INDIVIDUALS EXPERIENCING
PERMANENT OR TEMPORARY MEDICAL HAIR LOSS PROVIDED:
(I) A LICENSED PROVIDER PRESCRIBES SUCH CRANIAL PROSTHESIS FOR A
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.
LBD04171-01-5
A. 2683 2
CHRONIC ILLNESS, OR INJURY, INCLUDING, BUT NOT LIMITED TO, ALOPECIA
AREATA, ALOPECIA MEDICAMENTOSA, SCARRING ALOPECIA, AND LUPUS;
(II) THE POLICY PROVIDES COVERAGE FOR A CRANIAL PROSTHESIS TO A
COVERED PERSON NO MORE FREQUENTLY THAN ONCE EVERY TWELVE MONTHS; AND
(III) THE COVERAGE IS LIMITED TO SEVEN HUNDRED FIFTY DOLLARS FOR EACH
INSTANCE OF COVERAGE, AND SHALL BE SUBJECT TO ANY COST-SHARING REQUIRE-
MENTS THAT ARE OTHERWISE APPLICABLE.
(B) FOR PURPOSES OF THIS PARAGRAPH, THE TERM "CRANIAL PROSTHESIS"
MEANS A WIG OR HAIRPIECE.
§ 4. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 23 to read as follows:
(23) (A) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIV-
ERY IN THIS STATE THAT PROVIDES COVERAGE FOR PROTHESES SHALL PROVIDE
COVERAGE FOR CRANIAL PROSTHESES FOR INDIVIDUALS EXPERIENCING PERMANENT
OR TEMPORARY MEDICAL HAIR LOSS PROVIDED:
(I) A LICENSED PROVIDER PRESCRIBES THE CRANIAL PROSTHESIS FOR AN
ENROLLEE'S COURSE OF TREATMENT FOR THE DIAGNOSED HEALTH CONDITION,
CHRONIC ILLNESS, OR INJURY, INCLUDING, BUT NOT LIMITED TO, ALOPECIA
AREATA, ALOPECIA MEDICAMENTOSA, SCARRING ALOPECIA, AND LUPUS;
(II) THE POLICY PROVIDES COVERAGE FOR A CRANIAL PROSTHESIS TO AN INDI-
VIDUAL ENROLLEE NO MORE FREQUENTLY THAN ONCE EVERY TWELVE MONTHS; AND
(III) THE COVERAGE IS LIMITED TO SEVEN HUNDRED FIFTY DOLLARS FOR EACH
INSTANCE OF COVERAGE, AND SHALL BE SUBJECT TO ANY COST-SHARING REQUIRE-
MENTS THAT ARE OTHERWISE APPLICABLE.
(B) FOR PURPOSES OF THIS PARAGRAPH, THE TERM "CRANIAL PROSTHESIS"
MEANS A WIG OR HAIRPIECE.
§ 5. Section 4303 of the insurance law is amended by adding a new
subsection (ww) to read as follows:
(WW)(1) A HOSPITAL SERVICE CORPORATION, HEALTH SERVICE CORPORATION OR
MEDICAL EXPENSE INDEMNITY FUND WHICH PROVIDES COVERAGE FOR PROSTHESES
SHALL PROVIDE COVERAGE FOR CRANIAL PROSTHESES FOR INDIVIDUALS EXPERIENC-
ING PERMANENT OR TEMPORARY MEDICAL HAIR LOSS PROVIDED:
(A) A LICENSED PROVIDER PRESCRIBES THE CRANIAL PROSTHESIS FOR AN
ENROLLEE'S OR SUBSCRIBER'S COURSE OF TREATMENT FOR THE DIAGNOSED HEALTH
CONDITION, CHRONIC ILLNESS, OR INJURY, INCLUDING, BUT NOT LIMITED TO,
ALOPECIA AREATA, ALOPECIA MEDICAMENTOSA, SCARRING ALOPECIA, AND LUPUS;
(B) THE CONTRACT PROVIDES COVERAGE FOR A CRANIAL PROSTHESIS TO AN
INDIVIDUAL ENROLLEE OR SUBSCRIBER NO MORE FREQUENTLY THAN ONCE EVERY
TWELVE MONTHS; AND
(C) THE COVERAGE IS LIMITED TO SEVEN HUNDRED FIFTY DOLLARS FOR EACH
INSTANCE OF COVERAGE, AND SHALL BE SUBJECT TO ANY COST-SHARING REQUIRE-
MENTS THAT ARE OTHERWISE APPLICABLE.
(2) FOR THE PURPOSES OF THIS SUBSECTION, THE TERM "CRANIAL PROSTHESIS"
MEANS A WIG OR HAIRPIECE.
§ 6. This act shall take effect immediately and shall apply to any
policy issued, delivered, renewed, and/or modified on or after such
effective date.