National External Breast Prostheses Reimbursement Program

Information on the program and how to claim a reimbursement.

Page last updated: 10 July 2017

This national program aims to improve the quality of life of women who have undergone breast surgery (including a full or partial mastectomy or a lumpectomy) as a result of breast cancer.

The program, which 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 breast surgery as a result of breast cancer.

All women who are permanent residents of Australia, have a current Medicare entitlement and have had breast surgery (including a full or partial mastectomy or a lumpectomy) as a result of breast cancer, are eligible to claim the reimbursement. The surgery 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 on prostheses purchased 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 Department of Human Services website, or by calling the Department of Human Services on 132 011 (call charges may apply), or visiting a Medicare office.