Medicare Rebates & Claims for Breast Forms
Medicare Rebates for Breast Forms
The Australian Government’s External Breast Prostheses Reimbursement Program provides a reimbursement of up to $400 for a prosthesis or up to $800 if you need a prosthesis for both breasts following a double mastectomy. The reimbursement amount covers an external breast prosthesis or an external swimming prosthesis for people who have had breast surgery as a result of breast cancer.
The breast surgery may be recent or in the past (no time limit). This includes:
- double mastectomies
- prophylactic mastectomies - preventative surgery
- partial mastectomies
- lumpectomies
Who can claim
· No timeframes apply on when the breast surgery was performed.
· To claim the reimbursement, your prosthesis must have been purchased after July 1st, 2008.
· You can claim the reimbursement every 2 years from the date of your last purchase. Should you require a new prosthesis within the 2 year period, you can only claim for a replacement if it is for a medical reason.
How to claim
1. Breast Care Victoria will assist you in completing the External Breast Prosthesis Reimbursement Program form and will email the completed form and receipt to EBPR on your behalf. You will receive a copy of the email. Click on this link for more info: Claim for External Breast Prostheses Reimbursement Program form (NH005) - Services Australia
OR
2. To complete the Medicare form yourself, click on this link: Claim for External Breast Prostheses Reimbursement Program form (NH005) - Services Australia Scroll to the bottom of the page where you’ll find a hyperlink to download the External Breast Prostheses Reimbursement Program form (NH005). Once downloaded, you can either fill it out digitally or print it and complete it by hand. Then, email a copy of the completed form along with your tax invoice receipt to: ebpr@servicesaustralia.gov.au (This can be done by scanning the physical documents or screenshotting digital documents)
The External Breast Prostheses Reimbursement Program cannot be claimed through the Medicare app, as each claim is processed manually.