National External Breast Prostheses Reimbursement Program

Information on the Program and how to claim a reimbursement.

This national Program aims to improve the quality of life of women who have undergone mastectomy as a result of breast cancer.

The program, which the Government commenced on 1 December 2008, provides reimbursements of up to $400 for both new and replacement external breast prostheses for eligible women who have had a mastectomy as a result of breast cancer.

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 eligible to claim the reimbursement. The mastectomy may be recent or in the past. Women who currently receive financial assistance from the Department of Veterans’ Affairs (DVA) should continue to claim their entitlement through DVA.

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 (including any rebates obtained from a private health fund). The $400 limit applies to each prosthesis for each breast.

If a claim has previously been made under this program, a subsequent reimbursement can be claimed no earlier than two years from the date of last purchase. This applies to each prosthesis for each breast.

More information about the program, including eligibility criteria, a fact sheet and claim form, can be accessed on the Human Services website, or by calling Medicare Australia on 132 011 (call charges may apply), or visiting a Medicare Australia office.