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The Fitting Room > Medicare & Insurance Reimbursement For After Care Products |
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 What Your Coverage May Include
Many women do not take advantage of their Medicare and private insurance reimbursement Benefits for the specialty products they may need because they do not know they are eligible.
Following a diagnosis of breast cancer and subsequent surgery, your coverage may include:
- SOFTEE® Recovery Camisoles, breast prostheses and bras for all women who have a mastectomy.
- SOFTEE® Recovery Camisoles or temporary prostheses and pocketed bras during the stages of breast reconstruction.
- Permanent prostheses and bras for women who complete breast reconstruction and may require enhancement to create a balanced appearance.
- Prostheses and bras for lumpectomy surgeries which result in one breast appearing smaller in size.
Coverage for the SOFTEE®
In addition to bras and prostheses, Medicare and many private insurance companies will reimburse for the SOFTEE® post surgery Recovery Camisole, which can be worn home from the hospital and throughout the 6-8 weeks of healing.
It is best to check with your insurance company before your fitting to determine benefit coverage. Your insurance may require preauthorization before they will pay.
Other coverage could include:
- Medicare benefits allow for the purchase of bras every year and a breast prosthesis for each surgery every two years, regardless of when you had surgery. They will replace more often if there is a significant change in the body or weight.
- Most private insurance companies, HMOs (Health Maintenance Organizations), and PPOs (Preferred Physician Organizations) will cover the cost of the first prostheses and bra fitting, then replacement prostheses and pocketed bras at least every two to three years.
What You Will Need to Take with You When You Go to Purchase Specialty Products
- Your Medicare red-white-blue card
- Your primary insurance ID card, and secondary ID card if you have additional coverage.
- If applicable, a prescription or a referral from your primary care physician
For a prosthesis and bra fitting it is always best to call ahead and make an appointment.
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