Healthcare Provider FAQs
Breast cancer patients go through different phases in their breast surgery journey. Despite a surgeon's best efforts, many patients experience asymmetry after lumpectomy and radiation, chestwall asymmetry after mastectomy and failed reconstruction attempts. We do not have to leave these patients with deficits--we can use prosthetics to provide symmetry, balance and confidence. Prosthetics can be used at various stages of breast surgery and reconstruction.
What choices are available to my patient after mastectomy?
Standard breast prosthesis-an off the shelf prosthetic with limited color choices and various sizes to match the remaining breast.
Custom breast prosthesis-a prosthesis tailored made to match the skin tone and architecture of the chestwall. It comes in 31 different shades to match all skin tones and ethnicities.
What choices are available to my patient after lumpectomy?There are partial prosthetics in varied shapes and sizes to help fill in volume loss after lumpectomy. For patients with severe asymmetry, a custom partial prosthesis can be created with 31 different shades to match all skin tones and ethnicities.
What choices are available for my patient undergoing reconstruction?Prosthetics can play an important role and assist the patient with symmetry while undergoing the various stages of reconstruction. A layered prosthesis can be used with expanders to provide symmetry for the active patient. The layers peel away during the phases of expansion. A standard prosthesis can assist with patients undergoing delayed reconstruction or need a break in between procedures.
Are prosthetics and bras covered by insurance?Yes, bras and breast prosthesis are categorized as Durable Medical Equipment (DME). These are covered by most insurance plans with a written order by a licensed medical provider. We have order forms on our website for your convenience that meet all the insurance requirements.
How many prosthetics and bras are covered for my patient?This can vary by insurance carrier, our team can assist your patient. Most insurances provide one silicone prosthesis per mastectomy site every other year. There are other non-silicone prosthetics (i.e. active forms) that can be replaced sooner.
What's a breast prosthetic?
An artificial breast that is placed in a bra, or directly on the skin for use after a woman’s own breast has been surgically altered or removed.
Whether the loss of the breast is permanent or temporary, a breast prosthesis can be worn to simulate the natural breast shape. Wearing a breast prosthesis is a highly popular personal choice. Many women choose to wear one because they want to wear the same clothing that they wore prior to the surgery and they want to look symmetrical.
We accept the following insurance providers:
- CareFirst Blue Cross Blue Shield
- Virginia Anthem Blue Cross Blue Shield
- All out-of-state Blue Cross Blue Shield family of companies
- Amerigroup
- Aetna
- Cigna
- Colonial Life
- Medicare
- Maryland Medicaid (Not issued by another insurance company)
- Tricare
- Virginia Medicaid (Not issued by another insurance company)
We will soon be able to handle all medical insurance billing in-house.
Click this link to be notified as to when we can accept other individual insurance providers.