STATE OF NEW YORK
________________________________________________________________________
4961
2025-2026 Regular Sessions
IN SENATE
February 14, 2025
___________
Introduced by Sen. BAILEY -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law, in relation to providing insurance
coverage for cranial prostheses
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subsection (i) of section 3216 of the insurance law is
2 amended by adding a new paragraph 40 to read as follows:
3 (40) (A) Every policy which provides coverage for prostheses shall
4 provide coverage for cranial prostheses for individuals experiencing
5 permanent or temporary medical hair loss provided:
6 (i) a licensed provider prescribes such cranial prosthesis for a
7 covered person's course of treatment for the diagnosed health condition,
8 chronic illness, or injury, including, but not limited to, alopecia
9 areata, alopecia medicamentosa, scarring alopecia, and lupus;
10 (ii) the policy provides coverage for a cranial prosthesis to a
11 covered person no more frequently than once every twelve months; and
12 (iii) the coverage is limited to seven hundred fifty dollars for each
13 instance of coverage, and shall be subject to any cost-sharing require-
14 ments that are otherwise applicable.
15 (B) For purposes of this paragraph, the term "cranial prosthesis"
16 means a wig or hairpiece.
17 § 2. Subsection (l) of section 3221 of the insurance law is amended by
18 adding a new paragraph 23 to read as follows:
19 (23) (A) Every group or blanket policy delivered or issued for deliv-
20 ery in this state that provides coverage for protheses shall provide
21 coverage for cranial prostheses for individuals experiencing permanent
22 or temporary medical hair loss provided:
23 (i) a licensed provider prescribes the cranial prosthesis for an
24 enrollee'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.
LBD07940-01-5
S. 4961 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 an indi-
4 vidual enrollee 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 § 3. Section 4303 of the insurance law is amended by adding a new
11 subsection (ww) to read as follows:
12 (ww) (1) A hospital service corporation, health service corporation or
13 medical expense indemnity fund which provides coverage for prostheses
14 shall provide coverage for cranial prostheses for individuals experienc-
15 ing permanent or temporary medical hair loss provided:
16 (A) a licensed provider prescribes the cranial prosthesis for an
17 enrollee's or subscriber's course of treatment for the diagnosed health
18 condition, chronic illness, or injury, including, but not limited to,
19 alopecia areata, alopecia medicamentosa, scarring alopecia, and lupus;
20 (B) the contract provides coverage for a cranial prosthesis to an
21 individual enrollee or subscriber no more frequently than once every
22 twelve months; and
23 (C) the coverage is limited to seven hundred fifty dollars for each
24 instance of coverage, and shall be subject to any cost-sharing require-
25 ments that are otherwise applicable.
26 (2) For the purposes of this subsection, the term "cranial prosthesis"
27 means a wig or hairpiece.
28 § 4. This act shall take effect immediately and shall apply to any
29 policy issued, delivered, renewed, and/or modified on or after such
30 effective date of this act.
