Commonly Asked Insurance Questions

Does my insurance cover my mastectomy products?

Yes, Almost all insurance companies cover a breast prosthesis, bras & garments following a mastectomy, lumpectomy, or if you choose reconstruction surgery. Some plans do require pre-authorization, so please call out office for more information.

Even though my mastectomy was several years ago, will my insurance cover these items?

Yes, time is not relevant to the insurance coverage criteria. They will cover it whether your surgery was one week ago or 40 years ago.

How much will my insurance cover?

It depends on your policy most insurances cover 80% of the allowable, call for specific details on your personal insurance coverage.

How often does my insurance cover these items?

Most Insurance companies will cover these items once a year. Call for more details.

Will my insurance cover anything if I had a Lumpectomy or Reconstruction instead of a Mastectomy?

Yes, the insurance coverage criteria is the same regardless of breast surgery type.

Do you accept Assignments?

Yes, we do participate with most insurance companies, Call for more details.

What are Assignments?

The Insurance company sets an allowable dollar amount to use for your needed product. Unless the provider accepts assignments on the product you will have to pay the difference between the cost and the allowable amount. Our Office DOES accept assignment on MOST of our products, which means we write off the difference between the allowable amount. There may be a portion the patient is required to pay if they choose to get an upgraded product. Call for more details.

Does Medicaid pay for these products?

Yes, Both TN & VA Medicaid cover these products. If you have VA Medicaid– you must have prior authorization in order for them to cover. Before scheduling your appointment , please have a prescription from your doctor to expedite the process. Tennessee Medicaid patients, please call to see what your insurance requirements are.

Still have questions? Email Us or call us at 423-573-8500.