The cost of a breast prosthesis and bra varies depending on the type. If the cost of the prosthesis is an issue, you may choose not to replace the prosthesis regularly because of the cost.
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Guide to the average cost of each prosthesis and bra
| silicone breast prosthesis | $300–$500 |
| partial breast prosthesis | $150–$200 |
| silicone swim prosthesis | $150–$200 |
| foam prosthesis | about $70 |
| mastectomy bra | $40–$100 |
| bra pocket that you can sew into a regular bra | $10–$15 |
Reimbursement from Medicare
The cost of a new or replacement breast prosthesis can be claimed through Medicare. You can claim for a new prosthesis every 2 years if you’re a permanent resident of Australia, are eligible for Medicare, and have had a full or partial mastectomy as a result of breast cancer.
At the time of publication (2023), Medicare’s External Breast Prostheses Reimbursement Program provides up to $400 for each new or replacement breast prosthesis. If you’ve had a double (bilateral) mastectomy, you are eligible for reimbursement for 2 breast prostheses of up to $400 each.
Steps for making a claim for a replacement prosthesis
- Allow 2 years or more between the purchase dates of the prostheses. In some cases, you may be able to make additional claims but you will need to provide a letter from your doctor or surgeon.
- Claim any refund from your private health insurance first if you’re eligible.
- Obtain a claim form from any Medicare office, download it from servicesaustralia.gov.au or call Medicare on 132 011 to request a copy in the mail.
- Scan the original receipt, attach it to the claim form and return this by email, post or in person at a Medicare Service Centre. You cannot make a claim online (as at 2023). The payment will be made by electronic funds transfer into your bank account.
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Private health insurance
If you have private health insurance, check with your fund about what they cover. Rebates for breast prostheses and related products such as mastectomy bras vary between private health funds. Some rebates only apply to members with extras cover.
Most health funds have waiting periods and other terms and conditions. They may also require a letter from your surgeon or breast care nurse explaining why you need a prosthesis. Before buying a prosthesis, check with your health fund about what is covered and what information they need from you.
Even if you have made a claim through private health insurance, you may be able to claim a reimbursement from Medicare. If the full price of the prosthesis wasn’t covered by your private health insurer, you can claim through Medicare, but this reimbursement will be adjusted according to the $400 limit. For example, if you buy a prosthesis for $500, and get a $200 refund from your private health fund, your Medicare reimbursement would be $200.
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Key resource
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More resources
Dr Jane O’Brien, Specialist Oncoplastic Breast Cancer Surgeon, St Vincent’s Private Hospital, VIC; Clare Bradshaw, Clinical Nurse Consultant, Breast Assessment Unit, Fiona Stanley Hospital, WA; Rene Hahn, Consumer; Sinead Hanley, Consumer; Dr Marc Langbart, Specialist Plastic and Reconstructive Surgeon, Randwick Plastic Surgery, NSW; Melanie Law, Consumer; Sally Levy, Consumer; Annmaree Mitchell, Consumer; Ashleigh Mondolo, Breast Cancer Nurse Clinical Consultant, Mater Private Hospital Brisbane, QLD; Rochelle Osgood, Clinical Nurse Consultant – McGrath Breast Care Nurse, Sunshine Coast University Hospital, QLD: Dr Kallyani Ponniah, Head of Department, Breast Centre, Sir Charles Gairdner Hospital, WA; Meg Rynderman OAM, Consumer; Sarah Stewart, Breast Care Nurse, The Royal Women’s Hospital, VIC; Erin Tidball, 13 11 20 Consultant, Cancer Council NSW; Jane Turner, Senior Exercise Physiologist, Sydney Cancer Survivorship Centre, Concord Cancer Centre, NSW.
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