Once you get your breast prosthesis form, you might be concerned about traveling or going on vacation without knowing all the possible outcomes and situations that might arise. It is perfectly safe to wear and carry your prosthesis during all forms of travel, even air travel.

When you are traveling through airports and security checkpoints, you will still be required to have full-body scans, which will reveal your prosthesis to those who are watching the monitors. If your insert is detected via the body scan, you might be required to step to the side to have a brief pat-down over your clothing, at which time the airport security staff will simply feel the insert to ensure there is no danger, or nothing hidden within the form. The security staff should never ask you to remove your insert or require you to remove clothing to expose the form. They should have no need to directly touch your exposed breast prosthesis at any time.

Consider following these steps when planning to travel with your breast insert.

  • Let the security officer know that you wear a prosthesis, if you feel comfortable. You should also carry a letter from your doctor or breast surgeon with the make and model of the breast form, date it was received, and diagnosis.
  • Request to be screened in a private area and by a female security officer.
  • Pack your prosthesis or mastectomy bra in your carry-on bag if you do not want to wear it. The rules about liquids, gels and aerosols do not apply to silicone.
  • If you think you have not been treated with dignity or respect, let staff know. You can also complain in writing to airport management, the airline company, or the ADA.

How much will my breast prosthesis cost?

The costs of your inserts will vary on a few factors. But first, consider these questions:

  • Do you need only one insert, or two?
  • Which style of form will you need?
  • Full form, or a partial form?
  • What material will you choose?
  • Will you require or want an extra form, or one especially made for sports or swimming?
  • How long do you plan on keeping this one, or pair, of breast inserts?

Here are some of the average base prices, compiled from the top breast cancer agencies and organizations around the United States. The cost will depend and vary on every choice and aspect of the forms you choose. Price point often is a major factor in which form a woman chooses for herself.

  • Silicone breast form, full fit: $450–$950 per form
  • Silicone breast form, partial: $350-$800 per form
  • Shell breast form: $150-$500 per form
  • Nipple form: $40- $200 each
  • Nipple cover: $40-$200
  • Silicone swim form: roughly $150-$500 per form
  • Foam form: roughly $70 each
  • Mastectomy bra: $40–$100
  • Bra pockets (that can be sewn into a regular bra): $10 to $15 per pocket

Will insurance cover my breast prosthesis?

This solely depends on your insurance coverage, company, and what policy you have. In many cases, insurance will pay up to $400 per breast form, up to once every two years (although some offer more coverage). Medicare’s website states the following policy when it comes to covering breast prosthesis:

Medicare Part B (Medical Insurance) covers prosthetic devices needed to replace a body part or function when a doctor or other health care provider enrolled in Medicare orders them. These devices include:

  • Breast prosthesis including a surgical bra.
  • One pair of conventional eyeglasses or contact lenses provided after a cataract operation.
  • Ostomy bags and certain related supplies.
  • Some surgically implanted prosthetic devices, including cochlear implants.
  • Urological supplies.

With the original Medicare plan, you pay 20% of the Medicare-approved amount for external prosthetic devices, and the Part B Deductible applies. Medicare will only pay for prosthetic items furnished by a supplier enrolled in Medicare. It does not matter who submits the claim; you or your supplier.

To find out how much your test, item, or service will cost, talk to your doctor or health care provider. The specific amount you will owe may depend on several things, like:

  • Other insurance you may have
  • How much your doctor charges
  • Whether your doctor accepts assignment
  • The type of facility
  • Where you get your test, item, or service

You must go to a supplier that’s enrolled in Medicare for Medicare to pay for your device. Part A or Part B covers surgically implanted prosthetic devices depending on whether the surgery takes place in an inpatient or outpatient setting.”

Medicare also offers an External Breast Prosthesis Reimbursement Program, which can be found on the Medicare website or documents filled out through your provider.

Here is some information on how to make a claim for a replacement prosthesis:

  • Allow two years or more between the purchase dates of the prostheses. In some circumstances, you may be able to make additional claims, but you will need to provide a letter from your doctor or surgeon.
  • Obtain a claim form from any Medicare office.
  • Attach the original receipt to the claim form and return by email, post or in person at a Medicare Service location.

How can I file with my private insurance, or find out if they will cover my breast prosthesis?

Depending on who your insurance provider is, they will have a set plan in place for how to go about filing and getting a reimbursement for covered services or inserts. Some companies issue rebates or direct reimbursements, while others work with breast prosthesis companies to lower prices at purchase through their company partnership. Most all private insurance companies do have a waiting period and other terms before such prosthesis will be covered.

For the best outcome, contact your insurance carrier directly at the time of your breast cancer diagnosis and ask about which parts of breast prostheses are covered, and what you can expect. If you are a woman with multiple insurance companies, submit any unpaid portions to Medicare once your main insurance company has paid their portion. Medicare will often step in as a secondary insurance and help to cover costs your main insurance provider may not cover.

Citations:

American Cancer Society

National Institute of Health and Human Services

Breast Cancer Foundation

https://www.medicare.gov/coverage/prosthetic-devices