Medicare.gov

Breast prostheses

Medicare covers breast prostheses depending on where you get them

  • Covered by Part A
  • Covered by Part B

Coverage details

Medicare Part A (Hospital Insurance) covers surgically implanted breast prostheses after a mastectomy if the surgery takes place in an inpatient setting.

Medicare Part B (Medical Insurance) covers the surgery if it takes place in an outpatient setting. Part B also covers some external breast prostheses (including a post-surgical bra) after a mastectomy.

Costs

After you meet the Part B deductible , you pay 20% of the Medicare-approved amount for the doctor's services and the external breast prostheses.

Ask your doctor or healthcare provider how much your test, item, or service will cost.

Your doctor may recommend services that Medicare does not cover or offers too frequently. This could end up in additional costs for you. Make sure to ask your doctor about the reasons for these recommendations and what Medicare will actually cover.

Specific amounts you could owe depend on:

  • Other insurance you may have

  • How much your doctor charges

  • If your doctor accepts assignment

  • The type of facility

  • Where you get your test, item, or service