Reimbursement rates
You can get up to:
- $400 for a prosthesis following a single mastectomy
- $800 for double prostheses following a double mastectomy.
The total amount we reimburse will depend on the claim you make with us. We use the details in your claim to work out how much you get. This includes if you have private health insurance.
If you get financial assistance from the Department of Veterans’ Affairs (DVA), you should claim your entitlement through DVA.
Once you’ve claimed from your private health insurer, we may pay the difference if the reimbursement amount:
- is less than the full price you paid for it
- isn’t more than the $400 limit you can get for each prosthesis.
Example of claiming when you don’t have private health insurance
You’ve had a double mastectomy and required 2 prostheses. You bought the 2 prostheses for $130 each. You don’t have private health insurance. This means you can claim the full amount of $260 from us for the prostheses. This is because each prosthesis was under $400.
Example of claiming when you have private health insurance
You’ve had a single mastectomy. You bought the prosthesis for $400 and get $200 back from your private health insurer. You then make a claim with us and get another $200 back. This is the difference between the $400 limit we can give you and your private health refund amount.
Cover for the upfront cost of a prosthesis
If you get certain Centrelink income support payments, you may be eligible for an advance payment. You can use this to help cover the upfront cost before you claim.
You need to do the following:
- check if you meet the advance payment rules
- apply for the advance
- agree to the repayment schedule.
If you’re successful, you can use the advance payment to buy your prosthesis. Then claim reimbursement from us. You can use this money to pay back your advance or keep repaying it based on your agreed schedule.