Does Medicare Cover Mastectomy Bras?

Medicare Mart B covers mastectomy bras following a mastectomy. You are typically responsible for paying your Medicare Part B deductible and coinsurance costs for a mastectomy bra, and a Medicare Supplement insurance plan (also called Medigap) could help pay these Medicare costs.

Learn more about the Medicare mastectomy bra coverage limitations, costs and financial help options.

When Will Medicare Pay for Mastectomy Bras?

Medicare covers mastectomy bras those who have had a mastectomy or a reconstruction surgery for breast cancer. Specifically, they will cover mastectomy bras for beneficiaries who undergo a covered mastectomy or silicone (or equal) breast prosthesis when the pocket of the bra is used to hold the prosthesis.

External breast prosthesis garments are covered by Medicare for use during the postoperative period prior to a permanent breast prosthesis or as an alternative to a mastectomy bra and breast prosthesis. 

How Much Do Mastectomy Bras Cost With Medicare?

Medicare Part B requires a deductible of $226 per year in 2023. After you meet your deductible, you typically pay a 20 percent coinsurance payment for the remainder of the Medicare-approved amount for your mastectomy bra. 

Find a Medicare mastectomy bra supplier near you who is approved by and contracted with Medicare in order to qualify for coverage. Make sure they accept Medicare assignment, which means the supplier will only charge you the Medicare-approved amount for your mastectomy bra.

How Often Will Medicare Pay for Mastectomy Bras?

Medicare will cover as many mastectomy bras as determined to be medically necessary by your doctor.

Medicare will cover one silicone breast form (or two for a bilateral surgery) every two years or one foam form (two for bilateral surgery) every six months.

What Else Does Medicare Cover for Breast Cancer Patients?

Medicare provides coverage for additional services and items related to breast cancer. Services performed in an inpatient setting are covered by Medicare Part A and those performed in an outpatient setting are covered by Medicare Part B. 

A Medicare Supplement plan can help cover some or all of the Medicare out-of-pocket costs for cancer treatment.

• Mammograms
  Medicare covers annual screening mammograms along with diagnostic mammograms on a more frequent basis if medically necessary. Mammograms are typically performed in an outpatient setting and therefore covered by Medicare Part B.  
• Mastectomies and lumpectomies 
  A mastectomy or lumpectomy procedure is covered when determined to be medically necessary. The surgery is covered by Medicare Part A if performed in an inpatient setting or by Part B when performed in an outpatient setting.
• Breast prosthesis 
  Breast prosthesis are covered by Medicare Part B when preceded by a mastectomy.
• Chemotherapy and radiation therapy
  Both Medicare Part A (inpatient) and Part B (outpatient) provide coverage for chemotherapy and radiation therapy when administered for the treatment of breast cancer.
• Prescription drugs
  A Medicare Part D plan or a Medicare Advantage plan that includes prescription drug benefits may cover certain medications that are prescribed for the treatment of breast cancer or chemotherapy.