National External Breast Prostheses Reimbursement Programme

Information on the programme and how to claim a reimbursement.

Page last updated: 21 December 2015

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

The programme, 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 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 programme, 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 programme, 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.

Have your say on the National External Breast Prostheses Reimbursement Programme

The Department of Health has commissioned a social research company called Urbis to do an evaluation of the National External Breast Prostheses Reimbursement Programme. They would like to hear from women who have had a mastectomy as a result of breast cancer. If you are interested in participating, you may visit the National External Breast Prostheses Reimbursement Programme Evaluation website until Friday 26 February 2016 for more information on the evaluation and to access an online survey to share your views on the programme.