(as published in Breast Cancer Wellness magazine, Winter 2008)
Many women who have had breast surgery are not aware that their insurance may cover the purchase of bras and breast prosthesis, also known as breast forms. Most medical insurance policies base their coverage on Medicare standards which usually cover these products for breast operated women. However, the amount is dependent on the region as defined by Medicare.

If you are thinking “I don’t want a medical looking bra” or I don’t want a hot and sticky breast form”, there’s no need to worry. You can find many of your favorite bra styles, including lacy, feminine, everyday, comfortable, and active sports bras, as well as the latest breast forms such as the Climate breast forms by Amoena. The Climate breast forms optimally equalize the temperature with an innovative pad between the breast form20and chest wall, making the skin feel pleasantly dry due to the moisture- absorbing pad.

Effective April 1, 2002 Medicare guidelines deemed the useful lifetime expectancy of a silicone breast form is two (2) years, and a non-silicone form has an expected lifetime of six (6) months. However, a breast form can be replaced at any time if it is lost, irreparably damaged (this does not include ordinary wear and tear), or if there is a change in the patient’s medical condition necessitating a different type of item. If the patient’s medical condition changes, it must be documented by the patient’s physician submitting a new prescription which explains the need for a different type of breast form.

You are invited to look at the new and stylish breast care products that are available today! The first step is to locate the mastectomy retailers close to you. Then, call the retailer of your choice and determine if she is knowledgeable about your insurance. If you are covered by Medicare, be sure the retailer has a Medicare Supplier Number. The retailer may choose to handle your purchase in one of two ways.

1. They may request payment from you in full, and then bill your insurance or Medicare on your behalf so that the reimbursement check comes to you.
2. Or they may accept assignment. This will allow you to take the form without full payment, while the store files for direct reimbursement. In most cases, you will be expected to make a co-payment.

Amoena retailers are there to help you determine what’s covered by your health insurance and what’s not. Their desire is to help you find the right products for you.