Starting Jan. 1, 2027, California cancer patients undergoing chemotherapy will have insurance coverage for machine-based scalp-cooling caps designed to help them keep their hair. The new requirement, created by California Assembly Bill 1682, applies to large-group health plans and, pending federal approval and a determination of medical necessity, Medi-Cal.
Gov. Gavin Newsom signed AB 1682 on Sept. 27, 2026, according to KPBS. The outlet reports that starting Jan. 1, 2027, the law requires large-group health plans and Medi-Cal to cover FDA-cleared scalp cooling for eligible chemotherapy patients. Bill text reviewed by California Legislative Information specifies that a health insurance policy issued, amended or renewed on or after Jan. 1, 2027, shall provide coverage for prescribed scalp cooling connected with chemotherapy for people with cancer.
The treatments work by lowering the temperature of a patient's scalp during chemotherapy sessions, according to CBS News Sacramento, which reports that scalp-cooling systems reduce blood flow to hair follicles and limit the amount of chemotherapy medication reaching them. The station describes one such device, DigniCap, as a cooling cap fitted snugly over wet hair and connected to a machine that lowers scalp temperature.
Which Devices Qualify, and Which Don't
Not every cold-cap method will be covered. The same CBS News report notes that systems such as DigniCap and Paxman are covered under the law, potentially saving patients thousands of dollars in out-of-pocket costs. A California Health Benefits Review Program analysis cited by the station's report identified three FDA-cleared automated systems eligible under the law: Paxman, DigniCap and Amma.
Manual cold caps that are stored in a freezer or with dry ice are not included, per the same KPBS account. The law instead covers scalp cooling only when a clinician prescribes it to reduce hair loss from chemotherapy that uses drugs known to cause hair loss, according to CURE.
What's at Stake for Patients' Wallets and Hair
The financial upside for patients could be significant. CURE reports that without insurance, scalp cooling can add $2,500 to $5,000 in out-of-pocket costs — a bill that will now shift to large-group insurers and, conditionally, Medi-Cal once the law takes effect.
The treatment itself isn't guaranteed to work for everyone. CURE's reporting states that for many patients it reduces hair loss by up to 50% to 75%, but it does not work for everyone. That caveat matters for patients weighing whether to pursue the therapy once coverage becomes available.
Questions remain about how broadly the mandate will reach. The evidence available does not establish whether small-group or individual insurance plans fall under the requirement, and the Medi-Cal benefit remains contingent on federal approval and a medical-necessity determination, conditions that have not yet been confirmed as met.
