External Breast Prostheses Reimbursement Program
• What is the External Breast Prostheses Reimbursement Program?
This is a new Australian Government initiative to provide reimbursement of up to $400 for new or replacement external breast prostheses for Australian women who
have had a mastectomy as a result of breast cancer.
• What am I able to claim?
New and replacement external breast prostheses purchased from 1st July 2008 can be claimed.
• Can I claim other items?
No, the program does not cover other purchases such as bras or other products, mastectomy swimwear or internal prostheses, or external prostheses purchased
before 1 July 2008.
• How do I claim the reimbursement?
You will need to complete a claim form. The form is available from any Medicare office or you can download a copy from the website at
Medicare Australia.
Once you have completed the claim form, attach your original receipt, which includes a description of the purchase, and post to:
Medicare Australia GPO Box 9822 in your capital city, or hand in at any Medicare office.
• Who can claim the reimbursement?
All women who are permanent residents of Australia, have a current Medicare entitlement and have had a mastectomy as a result of breast cancer are eligible to
claim the reimbursement. The mastectomy may be recent or in the past.
Exceptions:
If you currently receive financial assistance from the Department of Veterans' Affairs (DVA) you should claim your entitlement through DVA.
• How much is the reimbursement?
A reimbursement of up to $400 for each new or replacement external breast prosthesis can be paid, depending on the cost of the prosthesis. This limit applies for
each prosthesis for each breast.
Examples:
- If you have had a bilateral mastectomy and have purchased two prostheses at a cost of $800, your reimbursement amount is $800#. If the cost of your purchase is
$600, the reimbursement amount is paid up to the total cost of $600#.
- If you have purchased a single prosthesis at a cost of $500, the reimbursement amount is $400#.
• How often can I claim a reimbursement?
If a claim under this program has previously been made, a subsequent reimbursement can be claimed no earlier than 2 years from the date of last purchase. This
applies for each prosthesis for each breast.
• Can I claim the reimbursement if I have received a refund from my health fund or financial assistance for a state or territory program?
Yes, but only if you receive less than the full purchase cost and if the refund or financial assistance is less than the reimbursement limit. The amount of your
reimbursement will be reduced by the amount already received.
Example:
- If the cost of your purchase is $500 and you have received a refund of $200 for a single prosthesis from your health fund, the $200 is subtracted from the
reimbursement limit of $400. The reimbursement amount will be $200.
• How will the reimbursement be paid?
All reimbursements will be made by electronic funds transfer to your bank account you nominate on the claim form. We will send a statement to your nominated
postal address listing the amount deposited into your account which can be kept for taxation purposes.
• Where can I go to get more information?
Visit www.medicareaustralia.gov.au
Call 132 011* or visit any Medicare Office.
* Call charges may apply
# Subject to other refunds or financial assistance paid to you.
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