Illinois Wig Insurance Law: What SB 2573 Actually Says

Illinois Senate Bill 2573 is now law. It requires most Illinois insurance plans to cover one wig per year for qualifying medical conditions. Most patients who qualify have no idea this benefit exists.

This page is a plain-language breakdown of exactly what the law says, who it covers, and what you need to do to use it. Primary sources: the enrolled bill text at ILGA → and a Blue Cross Blue Shield of Illinois producer newsletter dated August 20, 2025 →

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The Short Version

If you have an Illinois insurance plan and you've experienced hair loss due to a medical condition, your insurer is now required to cover one wig per benefit period. You may not have been told. You are now.

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What the Law Requires

SB 2573 requires coverage of one wig or scalp prosthesis every 12 months for hair loss due to (read the enrolled bill →):

• Alopecia
• Chemotherapy
• Radiation for cancer
• Other conditions - the law's language is intentionally broad

That last point matters. The law does not limit coverage to cancer patients. Hair loss from thyroid conditions, trichotillomania, lupus, medication side effects, surgery, or other medical causes may all qualify under "other conditions." If your hair loss has a medical cause, it is worth asking your insurer directly.

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Which Plans Does SB 2573 Cover?

The enrolled bill amends the Illinois Insurance Code to require coverage under any group or individual plan of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed after January 1, 2026. The bill separately amends the Health Maintenance Organization Act and the Voluntary Health Services Plans Act to bring HMOs and health services plan corporations under the same requirement.

In plain terms, this covers:

• Individual and family health insurance plans
• Group plans through employers (PPO, HMO, and POS)
• Health Maintenance Organizations
• Voluntary Health Services Plans
• Small, mid-market, and large group plans
• Marketplace and ACA plans issued in Illinois

What it does not cover: Self-funded employer plans are governed by federal ERISA law, not state law, and are exempt from SB 2573. If your employer self-funds its health plan, this law may not apply, but your plan may still offer wig coverage voluntarily. Check your Summary Plan Description or call your HR department to find out whether your employer's plan is fully insured or self-funded.

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When Does It Take Effect?

The law applies to any plan amended, delivered, issued, or renewed after January 1, 2026. This means:

• If your plan renewed January 1, 2026, the benefit is already active
• If your plan renews mid-year, the benefit activates at that renewal date
• If you're not sure when your plan renews, check your insurance card or call the member services number on the back

Do not assume your benefit period started January 1. Many Illinois residents have mid-year renewals. Your benefit window is tied to your specific plan renewal date, not the calendar year.

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What "One Wig Per Benefit Period" Actually Means

The law provides coverage for one wig or scalp prosthesis per 12-month benefit period, not per calendar year. A few things worth understanding:

• Coverage is subject to your plan's allowed amount. Your insurer sets a maximum reimbursement figure and your out-of-pocket cost is the difference between that amount and the purchase price.
• The benefit resets at your plan renewal date, not January 1, unless your plan happens to renew on January 1.
• A wig and a scalp prosthesis count as the same benefit. You get one per period, not one of each.
• The benefit covers the purchase. Accessories, styling services, and replacement parts are separate.

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How to Claim the Benefit at Ferdinand's

Ferdinand's has been processing insurance reimbursement documentation for patients long before SB 2573 required it. The process is straightforward:

1. You purchase your wig at Ferdinand's and pay in full at the time of sale.
2. We prepare a medical invoice stamped with our NPI number (the National Provider Identifier that signals to your insurer that Ferdinand's is a legitimate medical provider).
3. We provide all supporting documentation required for your reimbursement claim.
4. You submit the claim to your insurer in writing, by mail rather than by phone.
5. Your insurer reimburses you directly, up to the allowed amount under your plan.

The reimbursement comes to you, not to us. You are in control of your own claim from the moment you walk out the door.

Why by mail? A phone call creates no record and obligates no one. A written submission creates a formal claim your insurer must respond to in writing, something you can reference and appeal if needed.

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What If You're Denied?

A denial is not a final answer. It is the opening of an appeals process. Most denials are addressable, especially for conditions that fall under the "other conditions" language in SB 2573, where the insurer may need additional documentation to connect your diagnosis to the coverage requirement.

If your claim is denied:

• Read the denial letter carefully. The reason given determines your appeal strategy
• A Letter of Medical Necessity from your treating physician strengthens most appeals
• Ferdinand's can provide supporting documentation for your appeal
• The National Alopecia Areata Foundation's reimbursement guide → walks through the full appeals process

The Illinois Department of Insurance handles complaints against insurers who fail to comply with state coverage mandates. If you believe SB 2573 applies to your plan and your insurer is not honoring it, that is a filing option.

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HSA and FSA

A cranial prosthesis qualifies as a medical expense under IRS guidelines. HSA and FSA funds can be used toward your purchase at Ferdinand's regardless of whether you are also filing an insurance claim.

Whether insurance can cover one portion of the cost and HSA or FSA cover the remainder is a question for your plan administrator, as the rules vary. We recommend asking before you purchase if this combination is important to your decision.

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Outside Illinois?

Illinois is one of 19 states with a wig coverage mandate. The specific conditions covered, reimbursement amounts, and plan types included vary by state. If you are outside Illinois, the reimbursement process at Ferdinand's works the same way. We provide proper documentation and NPI-stamped invoices for patients in any state. Whether your specific plan covers it depends on your state's law and your plan type.

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More on Insurance & Reimbursement

For the full picture on how insurance reimbursement works at Ferdinand's, including Medicare, Medicaid, HSA, and out-of-state coverage, see our Insurance & Reimbursement overview →

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Ready to Use Your Benefit?

You don't need to have the insurance side sorted before you call. We'll walk through your specific situation as part of your consultation: coverage, documentation, and what to expect from your insurer.

Before the paperwork, most people want to know whether a wig can actually look like them. Our guide to natural looking wigs explains how shape, hairline, color, density, and fiber affect the result.

Ferdinand's has been serving medical hair loss patients since 1962. We have an established NPI number, a documented reimbursement workflow, and years of experience navigating exactly this process with patients across Illinois and beyond.

Book a Consultation →

Or call us at 309-682-8423 during business hours.

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Frequently Asked Questions