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S 4961

Provides insurance coverage for cranial prostheses

2025 Regular Session Introduced by Jamaal Bailey

Summary of Senate Bill S 4961: Provides Insurance Coverage for Cranial Prostheses OverviewSenate Bill S 4961, introduced on February 14, 2025, aims to require health insurance plan

REPORTED AND COMMITTED TO FINANCE
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Bill Summary · S 4961

Summary of Senate Bill S 4961: Provides Insurance Coverage for Cranial Prostheses

Overview

Senate Bill S 4961, introduced on February 14, 2025, aims to require health insurance plans to provide coverage for cranial prostheses, which are often used by individuals who have lost hair due to medical conditions or treatments.

Key Provisions

  • Mandates that all health insurance plans, including those provided through Medicaid, Medicare, and the individual/group insurance markets, cover the cost of cranial prostheses (wigs) for individuals who have experienced hair loss as a result of a medical condition or treatment.
  • Specifies that coverage must include the full cost of the cranial prosthesis, as well as any necessary fittings, adjustments, or repairs.
  • Prohibits insurance providers from imposing any annual or lifetime limits, deductibles, or copayments on this coverage.
  • Requires that coverage be provided without regard to the cause of the individual's hair loss, whether it is due to cancer treatment, alopecia, or another qualifying medical condition.

Affected Populations

  • Individuals who have experienced hair loss due to cancer treatment, alopecia, or other qualifying medical conditions
  • Families and caregivers of those affected by hair loss from medical causes
  • Health insurance providers operating in the Medicaid, Medicare, individual, and group insurance markets

Procedural and Timeline Aspects

  • S 4961 was reported and committed to the Senate Finance Committee on February 14, 2025, after being introduced.
  • If enacted, the bill would require insurance providers to comply with the new coverage mandate within 6 months of the law taking effect.
  • The bill is a reintroduction of a similar measure, S 9642, which was introduced but did not pass in the previous legislative session.

Overall, S 4961 aims to ensure that individuals who lose hair due to medical conditions or treatments have access to the cranial prostheses they need, without facing financial barriers or limitations from their health insurance providers.

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

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