Medicare Breast Prosthesis Reimbursement Program

All women who are permanent residents of Australia, have a current Medicare entitlement and have had a mastectomy as a result of breast cancer are now eligible to claim reimbursement for an external breast prosthesis. The mastectomy may be recent or in the past. The reimbursement program will commence December 1, 2008. However prostheses purchased from July 1, 2008 are eligible for reimbursement.

Medicare Australia will administer all reimbursements under the program. As of September 9 2008, a claim can be made via Medicare Australia. To claim the reimbursement for an external breast prosthesis, a claim form needs to be completed, which is available from any Medicare office, or it can be downloaded from the Medicare Australia website at www.medicareaustralia.gov.au. You can also contact Medicare Australia on 132 011 to request a form. 

Once a reimbursement is claimed under this program, subsequent reimbursements can be claimed no earlier than 2 years from the date of last purchase. This applies for each prosthesis for each breast. The amount that can be claimed is up to $400 for each new or replacement external breast prosthesis, depending on the cost of the prosthesis, and any other financial assistance already obtained. The $400 limit applies to each prosthesis for each breast.

Women who currently receive financial assistance from the Department of Veterans’ Affairs (DVA) should continue to claim their entitlement through DVA.

View the Medicare Brochure.

Last Updated on Monday, 08 February 2010 16:09