Oct 272011

Senior ladies that have had a mastectomy or lumpectomy frequently are looking for a cosmetic solution. Companies such as Ameona and Nearly Me provide mastectomy bras and brassieres for use with external silicon implant “falsies.” These bras will fit much better than a traditional bra for women that have had these medical procedures. Women who have this procedure often ask,”Does Medicare cover mastectomy implants?”

Yes. Medicare Part B will cover external silicone implants — with a physician order — once every two years. They will cover up to four mastectomy bras a year. Medicare will cover up to 80 percent of the allowed amount for each product, with the patient paying the final 20 percent payment. It will be necessary to find a medicare authorized supplier for these products, or else Medicare will not cover the products.

Additionally, Medicare supplement plans may also defray the cost of the 20 percent coinsurance. Medicare Advantage plans are required to cover anything original Medicare pays for, and in some cases the Medicare Advantage plan, be it in NY, CA, FL or TX, may pay more and the patient less than the 20% coinsurance amount.