Information & Resources

In AUSTRALIA: External Breast Prostheses Reimbursement Program

This National Reimbursement  began in July 2008 and assists women who have had a mastectomy due to breast cancer and covers the cost of a new or replacement external breast prosthesis.

Eligibility Basics:

• be eligible for Medicare
• had a mastectomy due to breast cancer

How Much Can You Claim?

If eligible, you are entitled to claim back the cost of a new breast form (external breast prosthesis) up to the value of $400 every two years for a single mastectomy.  For women who have undergone a double mastectomy the rebate value covers both prosthesis to the value of $800.

The rebate is paid upon approved original receipts of the breastform purchase and is capped to $400, you cannot claim more than the price paid for the breast form.

For more information, visit your local Medicare Office or visit the Australian Government Department of Human Services Website:

http://www.humanservices.gov.au/customer/services/medicare/external-breast-prostheses-reimbursement-program

In NEW ZEALAND: Breast Prosthesis Subsidy

The Breast Prosthesis Service Payment is payment to people who have undergone a partial or full mastectomy, either unilateral or bilateral, and/or have undergone a lumpectomy, have congenital needs, or have had reconstructive surgery, as specified by a specialist or general practitioner (GP).

The payments are to reduce the cost of purchasing breast prostheses and other related products. Sector Services, on behalf of the Ministry of Health, will pay this service payment to either the claimant or the supplier of the product.

Who can claim this service payment?

You may claim for this service payment if you:

• are a New Zealand citizen, or are ordinarily resident in New Zealand; and
• your specialist or GP gives you a current medical certificate with your NHI number, and confirms your need for breast prosthesis services.

How much can I claim?

Your entitlement is $613.33 (GST incl) per side for a 4-year period. You may claim any amount up to the total amount of $613.33 (or $1226.66 for bilateral) at any time during the 4-year entitlement period.

Note: The entitlement period begins on the date you make your first purchase from a supplier and ends 4 years from this date.

What can I use the service payment for?

The service payment is available to cover the cost of the following items only:

• breast prosthesis or breast forms (these may include standard breast forms, swim form, foam filler, shell prosthesis and lumpectomy shells)
• special bras to hold the breast prosthesis or breast forms
• surgical bras
• normal bras (the services include the modification of a normal bra to hold breast prostheses or breast forms, or modifications to alternative undergarments where a person cannot wear a bra due to their medical condition)
• modified swimwear to hold a swim form
• prosthetic nipples.

For more information visit the New Zealand Ministry of Health Website:

http://www.health.govt.nz/new-zealand-health-system/claims-provider-payments-and-entitlements/breast-prosthesis-subsidy

Other Useful Resources:

New Zealand

New Zealand Breast Cancer Foundation