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Bill

H 1223

An Act to ensure access to scalp and facial hair prostheses for children and adults with alopecia areata

194th Legislature (2025-2026) Introduced by Jamie Eldridge and 4 co-sponsors

Massachusetts bill requiring health insurers to cover hair and beard prostheses for alopecia areata patients, removing out-of-pocket costs for affected individuals.

Accompanied a new draft, see H4552
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Bill Summary · H 1223

Legislative bill overview

H 1223 requires health insurance plans in Massachusetts to cover scalp and facial hair prostheses (wigs, hairpieces, beard prosthetics) for individuals diagnosed with alopecia areata, an autoimmune condition causing hair loss. The bill mandates insurance coverage without specifying coverage limits, deductibles, or whether prior authorization requirements can be imposed.

Why is this important

Alopecia areata affects approximately 2% of the U.S. population and can cause significant psychological distress, particularly in children. Currently, most insurance plans classify hair prostheses as cosmetic and deny coverage, forcing patients to pay out-of-pocket for devices that many consider medically necessary for mental health and social functioning. This bill would remove that financial barrier for Massachusetts residents.

Potential points of contention

  • Insurance cost impact: Mandated coverage could increase insurance premiums for all policyholders, with unclear actuarial analysis of the financial burden
  • Definition and scope ambiguity: The bill doesn't specify which prostheses qualify, frequency of replacement coverage, or whether custom/high-end options must be covered versus basic alternatives
  • Medical necessity debate: Some argue hair loss from alopecia areata is primarily cosmetic rather than medically necessary, distinguishing it from prosthetics for cancer-related hair loss or other conditions
  • Implementation burden: Unclear whether prior authorization, documentation requirements, or dermatologist certification will be mandated or optional

Compiled from official sources — confirm details with the bill’s official record.

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