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Insurance Frequently Asked Questions

Will you file my Medicare Insurance Claim for me?

Yes, we will gladly file your Medicare Insurance Claim for each order of post-breast surgery products you place with us.  However, we do not file to any other supplemental insurance.


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What post-mastectomy products does Medicare cover?

Silicone breast forms, foam breast forms, mastectomy bras, post-mastectomy camisoles, and adhesive skin support attachments like our Security Patches.


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How many per year does Medicare cover?

Medicare covers one silicone breast form every two years.  If you have had a bilateral mastectomy Medicare covers one for each side every two years.  One or two foam forms every six months, and two to four mastectomy bras per year.


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What information do you need from me to file my Medicare Claims?

You will be sent a form which lists the required information and Medicare Supplier Standards as required by Medicare.  As stated on the Claim Form you will be required to obtain a doctor’s prescription for Surgical Bras and/or Breast Forms indicating side of surgery and diagnosis code as well as the doctor’s UPIN#.  Your doctor’s office is probably familiar with all of this information.  Scheduling a doctor’s appointment is not necessary to obtain this prescription; all of this information should be in your chart, and you can request a prescription over the phone.  You will be required to write down your Medicare Number and Letter which can be found on your Red, White and Blue card.  Fill in your date of birth and sign.  Mail the form and the prescription to our office at 1509 Southern Hills Drive, Ardmore, OK 73401. 


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How much will Medicare Pay for my breast forms and bras?

Medicare will pay up to 80% of what they call the allowable.  You can check with your local Medicare Carrier regarding allowable amounts.  For more information, call 1-800-MEDICARE (1-800-633-4227).


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When will I receive my Medicare Reimbursement check?

Your claim will be filed promptly and your reimbursement check will come directly to you.  The average claims takes approximately 60 days.


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Are wigs covered by insurance?

Medicare does not cover the cost of wigs.  Private insurance companies may cover wigs with a prescription that reads “CRANIAL PROSTHESIS”.  Check with your private insurance on their coverage policy.


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