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 |  | With Health Insurance: Copays + 10%-50% Coinsurance |  | Without Health Insurance: $15-$1,000+ |
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An external breast prosthesis can be used as an alternative to breast reconstruction after a lumpectomy or mastectomy, usually for breast cancer, or temporarily before reconstruction. The prosthesis can create the appearance of a breast or breasts under clothing, and can add weight to help posture and prevent muscle pain and spine curvature.
Typical costs: | - For patients with health insurance, out-of-pocket costs typically consist of doctor visit copays and coinsurance of 10%-50%. Under the Women's Health and Cancer Rights Act[1] , health insurance plans that cover mastectomy must also cover a prosthesis. For example, BlueCross BlueShield of North Carolina[2] covers external breast prostheses when they are medically necessary. Insurance plans typically cover replacement of a prosthesis every few years.
- For patients without health insurance, a breast prosthesis can cost about $15 to more than $500 each, or, for a patient who has had a double mastectomy, under $30 to more than $1,000 for a pair. A basic prosthesis made of foam tends to be priced at the lower end of the range, and a silicone prosthesis falls in the middle. A "contact," or adhesive prosthesis, which sticks directly to the skin rather than being held in the pouch of a mastectomy bra, tends to cost the most.
- For example, at Park Mastectomy, a non-silicone breast prosthesis[3] , which might be made of foam or polyfill, costs $12-$80. At the Simms/Mann UCLA Center for Integrative Oncology, a non-silicone breast prosthesis[4] costs $40-$80. At the Seattle Cancer Care Alliance, a non-silicone breast prosthesis[5] costs $150-$200. At MastectomyShop.com, a breast prosthesis for swimming[6] costs $75-$220.
- At Park Mastectomy, equalizers[7] , also called shapers or enhancers, for women who have had a lumpectomy, cost $50-$260. At the Simms/Mann UCLA Center for Integrative Oncology equalizers[8] cost $80-$225.
- For a silicon prosthesis[9] , the Simms/Mann UCLA Center for Integrative Oncoloy charges $215-$350. At NearlyYou.com, a silicone prosthetic breast[10] costs $90-$250. Seattle Cancer Care Alliance, meanwhile, charges $245-$390 for a silicone breast prosthesis[11] .
- At Park Mastectomy, adhesive breast forms[12] that stick directly to the chest cost $130-$265. At the Seattle Cancer Care Alliance, a "contact form" breast prosthesis[13] costs $400-$550.
Related articles: Breast Cancer Treatment, Breast Reconstruction, Chemotherapy, Health Insurance
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What should be included: | - About a month after surgery, a certified mastectomy fitter will measure a patient and help the patient decide what kind of breast prosthesis will work best for her needs. Points to consider include comfort, lifestyle, appearance and the size and shape of the remaining breast, if the patient has one.
- Options include a non-silicone breast prosthesis, which is less expensive and lighter, or a silicone breast prosthesis, which tends to look more natural and weighs more to balance posture and help avoid back problems.
- BreastCancer.org offers an overview of breast prostheses[14] .
Additional costs: | - Some breast forms are designed to be attached directly to the body, but others fit into a specially designed mastectomy bra. At the Simms/Mann UCLA Center for Integrative Oncology, a mastectomy bra [15] costs from $36-$65. Insurance companies often cover two or more new bras every six months to a year, according to Simms/Mann.
- A breast prosthesis typically needs to be replaced every two years, which usually is covered by insurance.
Discounts: | - Some non-profits offer financial assistance for prosthetic breasts. For example, the All4One Alliance has programs[16] that provide up to $300 per year toward a prosthetic breast and $100 a year toward a post-mastectomy garment.
Shopping for a breast prosthesis: | - The American Cancer Society offers a list of breast prosthesis manufacturers and mastectomy shops[17] where patients can get fitted for and purchase a breast prosthesis.
- A patient should be fitted for a breast prosthesis by a mastectomy fitter who is certified by the American Board for Certification in Orthotics, Prosthetics and Pedorthics[18] or the Board for Orthotist/Prosthetist Certification[19] . The Amputee Coalition offers tips on choosing a prosthetist[20] .
- Cancer.net offers a guide[21] to choosing a breast prosthesis.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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External Resources: | - www.cancer.org/treatment/findingandpayingfortreatment/managinginsuranceissues/wome...
- www.bcbsnc.com/content/providers/news-and-information/news/Orthotic%20prosthetic%2...
- www.parkmastectomy.com/category/Foam-Polyfil-Breast-Forms.html
- www.simmsmanncenter.ucla.edu/reflections/section/breast_prostheses_bras.asp
- www.seattlecca.org/breast-prosthetics-mastectomy-bras.cfm
- www.mastectomyshop.com/categories/Breast-Forms/Swim-Form/
- www.parkmastectomy.com/category/Breast-Form-Lumpectomy.html
- www.simmsmanncenter.ucla.edu/reflections/section/breast_prostheses_bras.asp
- www.simmsmanncenter.ucla.edu/reflections/section/breast_prostheses_bras.asp
- www.nearlyou.com/
- www.seattlecca.org/breast-prosthetics-mastectomy-bras.cfm
- www.parkmastectomy.com/category/Attachable-Breast-Forms.html
- www.seattlecca.org/breast-prosthetics-mastectomy-bras.cfm
- www.breastcancer.org/treatment/surgery/reconstruction/prosthetics
- www.simmsmanncenter.ucla.edu/reflections/section/breast_prostheses_bras.asp
- www.all4onealliance.org/breast-cancer-resources/
- www.cancer.org/cancer/breastcancer/moreinformation/breast-prostheses-and-hair-loss...
- www.abcop.org/certification/CertifiedFitterMastectomy/Pages/Default.aspx
- www.bocusa.org/mastectomy-fitter-certification-cmf
- www.amputee-coalition.org/first_step_2003/choosing-a-prosthetist.html
- www.cancer.net/all-about-cancer/cancernet-feature-articles/after-treatment-and-sur...
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