According to the Women’s Health and Cancer Act of 1998, insurance companies are required to provide benefits to post breast surgery patients. Benefits are provided to women who have had a mastectomy, reconstruction, lumpectomy, or surgery to achieve symmetry, between the breasts. Benefits provided are subject to deductibles, co-insurance applicable to your policy.
Pink Ribbon Boutique accepts Medicare, Medicaid, as well as most commercial insurances.
Medicare provides one silicone breast prosthesis per surgery side, every two years, up to 12 mastectomy bras per year, as well as two post surgery camisoles, the first year after surgery, and up to two foam leisure forms every year. Medicare does not cover swimwear or wigs.
Most commercial insurance companies allow one silicone breast prosthesis per surgery side, per year, and mastectomy bras every year. Most commercial insurance companies are now covering wigs.
we will be happy to contact your insurance company for you to determine what is covered under your individual plan.
If you would like Pink Ribbon Boutique to bill your insurance company, we would need the following documentation form your physician:
Script with information below
- Diagnosis code
- Doctor’s NPI number
- Number of Silicone Breast Prosthesis
- Number of Mastectomy Bras
- Statement that products are medically necessary.
Information needed from patient:
- Patient name
- Phone number
- Birth date
- ID number
If the patient is not the insured, we would need the above information for the insured.