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.
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