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Breast Prostheses Detailed
Coverage: Conditions that must be met before Medicare will provide coverage, and limits to coverage.
Medicare Part B covers external breast prostheses (including a post-surgical bra) after a mastectomy. Medicare Part A 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.
CoPayment: The amount you need to pay.
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.
Medicare Part: The part of Medicare that pays for this service or supply.
Organization Name: The organization name that this coverage topic is associated with.
Important Notes: Details regarding important notes about the coverage.
You must pay an annual $147 deductible for Part B services and supplies before Medicare begins to pay its share.