Did you know? Many breast care products are reimbursable

Adapted from Breast Cancer Wellness magazine, Winter 2008; last reviewed May 2012

Many women who have had breast surgery are not aware that their insurance may cover the purchase of post-operative garments, pocketed bras and breast prostheses, also known as breast forms. Most medical insurance policies base their coverage on Medicare standards which usually cover these products for post-operative breast care patients. However, the product coverage and allowed 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. Nikkora carries a large selection of many of your favorite bra styles, including lacy, feminine, everyday, comfortable and active sports bras, as well as the latest breast forms. Visit our Breast Forms and Bras pages for details on some of the brands and styles we carry.

Medicare guidelines deem 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 and a new prescription explaining the need for a different type of breast form must be provided.

The first step in exploring the new and stylish breast care products available today is to visit the Breast Forms area of our website and then give us a call. One of our specialists will gather the necessary information from you to help you determine what’s covered by your health insurance and what’s not. Our desire is to help you find the right products for you and provide the best experience possible to meet your needs.

Help for Those in Need

Many foundations offer financial assistance for the uninsured or under served. Note that each organization requires an application and all grants are subject to eligibility verification.

American Cancer Society
Referrals for financial assistance; some local offices provide transportation assistance, temporary housing, wig, prostheses, bras, or prescription assistance.

Financial grants available for transportation, homecare, childcare and pain medications. Linking Arms Program can provide grants for breast cancer patients to help with selected supply costs.

Patient Advocate Foundation
Provides direct co-pay assistance for pharmaceutical products to insured breast cancer patients (including Medicare Part D beneficiaries) who financially and medically qualify.

Please speak with us if you are in financial distress about your medical expenses. We may be able to refer you to other resources and help to provide the services that you need while navigating this challenging journey.