Health care coverage: scalp cooling

Scalp cooling can reduce chemotherapy-related hair loss. The law extends coverage through large-group plans and Medi-Cal, subject to specified limits.

What the law does ​

• Requires large-group health plans and insurers issued, amended, or renewed on or after January 1, 2027, to cover prescribed scalp cooling for chemotherapy using hair-loss-inducing drugs.
• Limits covered scalp cooling to FDA-cleared medical devices or systems and excludes non-FDA-cleared cold caps and similar products.
• Allows cost sharing, but requires it to be no less favorable than cost sharing for oncology supportive-care services under the same coverage.
• Adds scalp cooling to Medi-Cal benefits, subject to medical necessity, utilization controls, federal approvals, and available federal matching funds.

Who it affects ​

• Patients receiving qualifying chemotherapy who are prescribed scalp cooling by a health care provider.
• Large-group health care service plans, large-group health insurers, and Medi-Cal managed care plans.
• Specialized health plans and specialized health insurance policies are excluded.

Context ​

Medi-Cal coverage is administered under separate rules from the large-group coverage mandate.