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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.
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.
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.
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.
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).
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.
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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