FAQ Friday: Does Medicare Cover Cosmetic Surgery after Breast Cancer?

The answer is yes, they do cover breast prostheses after a mastectomy. A breast prosthesis is an artificial breast form. It gives a breast a more natural shape after a mastectomy or breast-conserving surgery.

Medicare Part B covers external breast prostheses (including a post-surgical bra) after a mastectomy. Medicare also covers surgically implanted breast prostheses after a mastectomy. Medicare Part A (hospital benefit) covers the surgery if it takes place in an inpatient setting. Part B covers the surgery if it takes place in an outpatient setting.

All people with Medicare Part A and/or Part B are covered.

You pay 20% of the Medicare-approved amount for the doctor’s services and the external breast prostheses. The Part B deductible applies. For surgeries to implant breast prostheses in a hospital inpatient setting, you pay the Part A hospital care costs.