Your Medicare Coverage

Is my test, item, or service covered?

Breast prostheses

How often is it covered?

Medicare Part B (Medical Insurance) covers external breast prostheses (including a post-surgical bra) after a mastectomy. Medicare Part A (Hospital Insurance) covers surgically implanted breast prostheses after a mastectomy if the surgery takes place in an inpatient setting, and Part B covers the surgery if it takes place in an outpatient setting.

Who's eligible?

All people with Medicare are covered.

Your costs in Original Medicare

You pay 20% of the Medicare-approved amount for the doctor's services and the external breast prostheses.

For surgeries to implant breast prostheses in a hospital inpatient setting, you pay the Part A hospital care costs.

Note

To find out how much your specific test, item, or service will cost, talk to your doctor or other health care provider. The specific amount you’ll owe may depend on several things, like other insurance you may have, how much your doctor charges, whether your doctor accepts assignment, the type of facility, and the location where you get your test, item, or service.

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