Breast Prostheses Reimbursement Program

Thanks to Medicare’s External Breast Prostheses Reimbursement Program, mastectomy (and lumpectomy) patients can claim a reimbursement of up to $400 for a new or replacement external breast prosthesis every 2 years. Where a patient has undergone a bilateral mastectomy (or lumpectomy), she is entitled to claim a reimbursement of up to $800 every 2 years. No time frames apply on when the mastectomy was performed.

We stock a wide range of qualifying breast prostheses. Our invoices are tailored to meet the requirements set out by Medicare, to prevent any complications when claiming.

To be eligible, you must:

• be a permanent resident of Australia

• be eligible for Medicare

• have had a mastectomy or lumpectomy as a result of breast cancer

For more information regarding the program, you can visit the government website.

Please advise us if you are a Department of Veterans’ Affairs (DVA) Card Holder, as your claim will be processed through DVA, not Medicare. Please note that DVA requires a referral from your doctor before any claim can be processed. 

DVA Gold Card Holders are entitled to claim breast prostheses (every 2 years) plus up to four bras EVERY year, with no out of pocket expenses. We will lodge your claim on your behalf by directly billing DVA for your expenses.

Please note that not all Private Health Insurers will provide reimbursement towards your expenses, so you should check your entitlement before purchasing complementary devices such as bras & accessories. All of our receipts are tailored to meet the requirements of Health Insurance claiming.

Questions to ask your Health Insurance provider:

• Am I eligible to claim post-mastectomy products such as prostheses & bras?

• If so, what are my entitlements? E.g. it could be a specific dollar value, or a percentage of the total cost.

• When does my annual benefit / membership roll over?

Private Health Insurers who do not have a record of your hospital admission (for the purpose of a mastectomy / lumectomy) may request that you provide a letter of recommendation from your GP or Specialist Doctor, in order to establish your eligiblity / process your claim. This situation usually arises when you've switched Health Funds since your applicable surgery, or if you were admitted as a public patient in a public hospital.