External Breast Prostheses Reimbursement Program

Who can get money back

To get a reimbursement you must be enrolled in Medicare and have had breast surgery as a result of breast cancer.

What you can claim

You can get money back from us for the cost of new or replacement prostheses. You must have bought the prostheses after breast cancer surgery.

You’ll need to pay for the cost of the prostheses upfront. Then make a claim through your private health insurance before you seek a reimbursement from us.

If you get an income support payment, you may be eligible for an advance payment. You can use this to cover the upfront cost before you claim.

You can claim on behalf of someone who has died if you’re the executor or administrator of their estate.

What you can’t claim

Under the program you can’t claim for items such as:

  • bras
  • post breast surgery swimwear
  • internal prostheses
  • prosthetic nipple inserts.

If your prosthesis has deteriorated because of wear and tear within 2 years of buying it, you should either:

  • contact your private health fund to see if they cover a replacement
  • contact the shop where you bought the prosthesis to discuss replacement options.

How often you can claim

You can claim for new prostheses if it’s at least 2 years since you bought your last prosthesis. This applies regardless of your last reimbursement amount. We base this on the dates on your purchase receipts.

This information was printed Tuesday 21 May 2019 from https://www.humanservices.gov.au/individuals/services/medicare/external-breast-prostheses-reimbursement-program/eligibility-payment-rates/who-can-get-money-back It may not include all of the relevant information on this topic. Please consider any relevant site notices at https://www.humanservices.gov.au/individuals/site-notices when using this material.

Page last updated: 4 March 2019