Understanding Claims
By Tracey Grills
Owner of Tracey G Prosthetics and Lingerie
Have you had a mastectomy or Lumpectomy?
Medicare will reimburse you up to $400 per breast every 2 years ($800 for Bilateral). This is an anniversary date. DVA ladies can claim through DVA with a D904 from your GP for a prosthesis every 2 years and bras every year.
Do you have a Health fund?
Most health funds will assist with the cost of prosthesis and some also assist with bras and your wigs. Many may ask to prove you have purchased from Medicare first to claim a prosthesis, medicare will send a letter to say you have been paid then you can take that to your health fund. There are no provider numbers for sellers of mastectomy items so most claims need to be done via mail or in person. Your docket should clearly state: Mastectomy bra/garment to be able to claim from the health fund. Most health funds will assist with the cost of prosthesis and some also assist with bras and your wigs. Many may ask to prove you have purchased from Medicare first to claim a prosthesis, medicare will send a letter to say you have been paid then you can take that to your health fund. There are no provider numbers for sellers of mastectomy items so most claims need to be done via mail or in person. Your docket should clearly state: Mastectomy bra/garment to be able to claim from the health fund.
There are some key questions to ask of your fund:
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Do you cover for external breast prosthesis? What is my yearly allowance?
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Do you cover for post mastectomy/surgical bras? What is my yearly allowance?
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Is this every calendar year or financial year?
To have a fitting with Tracey visit her in one of her two stores in Brisbane and the Sunshine Coast.
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