I. Benefits for scalp hair prostheses shall conform to the requirements of N.H. Rev. Stat. § 415:18-d. Such benefits shall not be subject to any greater deductible than any other prostheses benefits provided by the health maintenance organization. The coinsurance required by the enrolled participant shall not exceed the amount allowed under the contract for the reasonable and customary charge for the services provided. Such coverage, however, shall be subject to a written recommendation by the treating physician stating that the hair prosthesis is a medical necessity. Such coverage shall be subject to the same limitations and guidelines as other prostheses.
II. For the purposes of this section:
(a) “Prostheses” means artificial appliances used to replace lost natural structures. Prostheses include, but are not limited to, artificial arms, legs, breasts or glass eyes.
(b) “Scalp hair prostheses” means artificial substitutes for scalp hair that are made specifically for a specific individual.