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Breast Prostheses Medicare Coverage Detailed

Your Medicare Coverage

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.

D

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.