SB 1114 revises Missouri’s existing prostheses coverage law to expand insurance coverage for scalp hair prostheses. Under current law, certain public coverage sources and state employee health plans must cover scalp hair prostheses for minors with hair loss from alopecia areata or alopecia totalis. The bill keeps that framework but adds a new requirement that any health benefit plan delivered, issued, continued, or renewed in Missouri on or after January 1, 2027, must also cover scalp hair prostheses for hair loss caused by cancer treatment.
The bill defines the relevant terms, including “health benefit plan,” “prostheses,” and “scalp hair prostheses,” and preserves the existing cost limits: coverage may not exceed $200 per calendar year or a $3,200 lifetime maximum, with an option for a one-time expenditure up to the lifetime cap for a more permanent prosthesis. It also maintains the rule that the benefit cannot be subject to a higher deductible or copayment than comparable services, while allowing insurers to offer more generous coverage if they choose.
Impact
SB 1114 would amend section 376.1222, RSMo, by expanding mandated insurance coverage for scalp hair prostheses from limited public and state employee coverage for certain pediatric alopecia cases to broader coverage in private health benefit plans for cancer-related hair loss. The bill would affect insurers and health benefit plans regulated in Missouri, requiring them to include this benefit for policies renewed or issued on or after January 1, 2027, while leaving the existing dollar caps and cost-sharing protections in place.
Sentiment
Based on the bill text and available context, the measure appears to be generally supportive and consumer-protective, aimed at helping people facing medically related hair loss obtain coverage for a prosthetic hair replacement. The caption and structure suggest a straightforward health insurance mandate rather than a controversial restructuring of benefits, and there is no recorded committee debate or vote history in the provided materials indicating organized opposition or support.
Contention
The main policy issue is the insurance mandate itself: the bill requires health plans to cover a specific prosthetic benefit for cancer treatment-related hair loss, which may raise concerns among insurers or employers about added premium costs and mandated-benefit expansion. Another point of potential contention is the continued use of relatively low annual and lifetime caps, which may limit the practical value of the coverage for some patients seeking higher-cost or more durable scalp hair prostheses. No specific objections or amendments are shown in the provided discussion materials.