Since January 1, 2026, class II hair prostheses are included in the 100% Health system. For public agents covered by the MGEN under the Complementary Social Protection (PSC), this change significantly alters the situation: the out-of-pocket expenses can drop to zero for certain devices. The mechanism relies on the interaction between the reimbursement base of Health Insurance and the obligations of the responsible contract subscribed to by the mutual insurance.
MGEN Responsible Contract and Hair Prosthesis: The Mechanism That Eliminates Out-of-Pocket Expenses
The decree of November 26, 2025, expanded the obligations of responsible contracts to hair prostheses. A responsible contract must legally supplement the reimbursement from Health Insurance up to the maximum selling price for devices included in the 100% Health basket.
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The PSC base entrusted to the MGEN / CNP Assurances group for state officials is a responsible contract. It therefore applies these rules. Specifically, for a hair prosthesis reimbursed by the MGEN mutual, Health Insurance covers a base amount raised to 350 euros for classes I and II, and the complementary insurance covers up to the legally set maximum selling price.
The result: zero out-of-pocket expenses in the regulatory basket, provided that the prescription procedure is followed and a certified supplier is chosen.
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Class I, Class II, Free: Which Hair Prosthesis to Choose with MGEN
The classification of hair prostheses directly determines the level of coverage. Three categories coexist, and the choice is not trivial.
Class I Prostheses
Completely synthetic, they are capped at 350 euros maximum selling price. Health Insurance reimburses based on this amount, and MGEN supplements it: no out-of-pocket expenses. This is the historical 100% Health basket for hair prostheses.
Class II Prostheses
Composed of at least 30% natural hair, they have benefited from the same mechanism since January 2026. The integration of class II prostheses into the 100% Health system is the major new development of 2026. The maximum selling price is regulated, and the MGEN responsible contract must cover the difference with the Health Insurance base.
Prostheses Outside the Basket (Free Class)
Here, prices are not capped. MGEN reimburses according to the guarantees of the contract, but out-of-pocket expenses often remain. The amount depends on the level of options subscribed in addition to the mandatory PSC base. Field reports vary on this point: some members report out-of-pocket expenses of several hundred euros for high-end prostheses, while others receive supplements through internal social action programs at MGEN.
PSC Mandatory Since May 2026: What This Changes for Teachers and Public Agents
Since May 1, 2026, complementary health insurance is collective and mandatory for state officials. The MGEN / CNP Assurances group manages this base for the National Education and several other ministries.
This obligation has a direct consequence on hair prostheses: all concerned agents automatically have a responsible contract, without the need for voluntary enrollment. Before this date, an agent who had not subscribed to mutual insurance bore the difference between the reimbursement from Social Security and the actual price of the device alone.
For agents who were already MGEN members before May 2026, the change is less visible. The PSC base retains guarantees similar to the former individual contract. However, for those who had no complementary insurance, access to full reimbursement for class I and II prostheses is now automatic.
Concrete Steps to Obtain MGEN Reimbursement for a Hair Prosthesis
The procedure consists of three steps, each of which conditions the next. An oversight in the prescription or the choice of supplier can turn a zero out-of-pocket expense into a significant bill.
- Obtain a medical prescription: the attending physician, dermatologist, or oncologist writes a prescription stating the need for a hair prosthesis. Without this prescription, no reimbursement is possible, either from Health Insurance or from MGEN.
- Choose a supplier approved by Social Security: only registered distributors allow for direct coverage. A purchase outside the approved network jeopardizes third-party payment and may reduce reimbursement.
- Submit the invoice and the care sheet to MGEN: if full third-party payment does not apply (in the case of prostheses outside the basket), the member pays the costs upfront and then sends the supporting documents via the MGEN member space to obtain the supplement.
Renewal is possible every twelve months for total prostheses, upon presentation of a new prescription. For hair accessories (turbans, headbands), the coverage conditions differ and the reimbursed amounts are lower.
Hair Accessories and Supplemental Coverage: The Blind Spots of MGEN Reimbursement
Textile accessories (turbans, medical scarves) are covered by Health Insurance, but the amounts remain modest. MGEN supplements according to the contract, without guaranteeing zero out-of-pocket expenses for these products.
For prostheses outside the basket whose prices far exceed the regulatory ceiling, some members turn to a supplemental health insurance. This type of contract, subscribed in addition to the PSC base, can cover all or part of the excess. The available data does not allow for a conclusion on the systematic cost/benefit ratio of these supplements: it all depends on the price of the chosen prosthesis and the additional monthly contribution.
The coverage of hair prostheses by MGEN has become clearer with the expansion of the 100% Health system and the mandatory PSC. For classes I and II, zero out-of-pocket expenses are secured with a simple prescription and an approved supplier. Beyond this scope, the actual level of reimbursement depends on the options chosen by each member.