Breast prostheses

Breast prostheses

How often is it covered?

 covers external breast prostheses (including a post-surgical bra) after a mastectomy.

Medicare covers surgically implanted breast prostheses after a mastectomy. 

 covers the surgery if it takes place in an inpatient setting. Part B covers the surgery if it takes place in an outpatient setting.

Who's eligible?

All people with Medicare Part A and/or Part B are covered.

Your costs in Original Medicare

You pay 20% of the 

 for the doctor's services and the external breast prostheses. The Part B 

 applies.

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 test, item, or service will cost, talk to your doctor or 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
  • Where you get your test, item, or service

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