Are Post Mastectomy Camisoles Covered by Insurance?

If you are looking into supplementing your post-mastectomy wardrobe with a post-mastectomy camisole, you may be wondering: Will my insurance cover my post-mastectomy camisole purchase? The answer to that question is fairly straightforward, with a few exceptions: Most insurance companies will cover the cost of breast prosthesis and post-mastectomy garments, including mastectomy camisoles. However, there may be some extenuating circumstance and clauses in your coverage that make obtaining that coverage a little bit more convoluted. The following is a guide to help you determine what is covered, what isn’t covered, and what to look for as well as where to look in your health insurance to find out which mastectomy garments are covered by your insurance company. Medicare coverage Medicare coverage sets the guidelines for what is and is not covered by health insurance. According to these guidelines, partial reimbursement can be granted for four to six mastectomy bras annually, and three medically necessary camisoles per month. However, additional bras or camisoles may be prescribed by your doctor if you experience significant weight gain or loss after surgery. Typically, your insurance is also required to cover these additional garment prescriptions, though the mastectomy camisole purchased must meet certain standards, such as the inclusion of pockets for breast prosthesis, in order to be covered by Medicare. Private insurance coverage Similar rules generally apply to private insurance, and the only major difference may be the number of post-surgical bras, or mastectomy camisoles that are covered by your plan, as well as the amount reimbursed for each product. It is important to contact your insurance agent or company to verify your exact benefits before scheduling a fitting to ensure t you are looking at the correct products from the start of your fitting. Talk to your certified fitter about which products your policy covers, how many garments are permitted annually, and how much is reimbursed for different pieces. With this information, a certified fitter can help you find and fit clothing in your price and product range...