External Breast Prostheses Reimbursement Program
The Australian Government has committed $31 million over five years to provide a reimbursement of up to $400 for both new and replacement external breast prostheses for Australian women who have had a mastectomy as a result of breast cancer. The program aims to ensure national consistency in the provision of support towards the cost of external breast prostheses.
Claiming the reimbursement
What am I able to claim?
You can claim a reimbursement for new and/or replacement external breast prostheses purchased from 1 July 2008.
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. No timeframes apply as to when the mastectomy was performed.
How much is the reimbursement?
A reimbursement of up to $400 for each new or replacement external breast prosthesis can be claimed, depending on the cost of the prosthesis. This limit applies for each prosthesis for each breast
Examples: if you have purchased a single prosthesis at a cost of $130, your reimbursement amount is $130†.
If you have had a bilateral mastectomy and have purchased two prostheses at a cost of $800, your reimbursement amount is $800†. If you purchased two prostheses at a cost of $1000, your reimbursement amount is $800.
(† The amount of your reimbursement will be reduced by the amount refunded or financial assistance already received.)
Can I claim the reimbursement if I have received a refund from my private health fund or financial assistance from a state or territory program?
Yes, if you received 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 you purchased a prosthesis at a cost of $500 and received a refund of $200 from your private health fund or state or territory program, your reimbursement will be $200.
Can I claim other items?
The program does not cover other purchases such as bras, mastectomy swimwear or internal prostheses.
How do I claim the reimbursement?
- Download the External breast prostheses reimbursement claim form [PDF, 217Kb]
- Visit your local Medicare office to pick up a brochure and claim form; or
- Call 132 011* and request a brochure and claim form be posted to you.
Your completed claim form, together with your original receipt that includes a description of the purchase may be handed in at your local Medicare office or sent to:
Reply Paid
Medicare Australia
GPO box 9822
Perth WA 6848
How often can I claim a reimbursement?
There must be a period of two years or more between the purchase dates of prostheses in order to make a further claim for reimbursement for replacement prostheses. This timeframe applies regardless of the amount originally reimbursed under the program.
How will the reimbursement be paid?
All reimbursements are made by Electronic Funds Transfer (EFT) to the bank account nominated 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.
Exceptions
If you currently receive financial assistance from the Department of Veterans’ Affairs (DVA) you should claim your entitlement through DVA.
For more information
- Visit your local Medicare office
- Email Medicare Australia at medicare@humanservices.gov.au
or the program directly at ebprp.programsupport@humanservices.gov.au - Call 132 011*
- TTY 1800 552 152 ** (hearing and speech impaired)
- TIS 131450* (Translating and Interpreting Service)
*Call charges apply
**Call charges apply from mobile and pay phone only.
Breast Cancer Network Australia
Breast Cancer Network Australia is the peak national organisation for Australians affected by breast cancer. If you or someone you know has been diagnosed with breast cancer, go to the Breast Cancer Network Australia
website for free information and support.
National Breast and Ovarian Cancer Centre
National Breast and Ovarian Cancer Centre (NBOCC) funded by the Australian Government, is Australia's independent national authority and information source on breast cancer and ovarian cancer. Visit the National Breast and Ovarian Cancer Centre website for more information.
National Breast Cancer Foundation
The National Breast Cancer Foundation (NBCF) funds research for the prevention and cure of breast cancer. Since the NBCF was established in 1994, over $67 million has been awarded to Australian based researchers across every state and territory, to improve the health and wellbeing of those affected by breast cancer. Visit the National Breast Cancer Foundation website for more information and to donate.
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Last updated: 7 July, 2011