Medicare and Private Insurance Filing

Dilettante Exclusively Yours provides Medicare and Private Insurance Filing for all our clients.

If you are covered by medicare, you are entitled to
One SILICONE BREAST FORM every 2 years ( 2 forms for bilateral surgery )
– OR –

One FOAM BREAST FORM every six months ( 2 forms for bilateral surgery)
– AND –

As many MASTECTOMY BRAS as MEDICALLY NECESSARY
 

L8000   Mastectomy Bras
L8001   Perma-Form/unilateral (Bra & Form)
L8002   Perma-Form/bilateral  (Bra & Form)
L8015   External Breast Prosthesis Garment
L8020   Foam Breast Form
L8030   Silicone Breast Form
L8031   Breast Prosthesis with Adhesive
L8032   Reusable Nipple Prosthesis
L8035   Custom Breast Prosthesis

MEDICARE IS PRIMARY: In order to qualify for partial Medicare reimbursement, a licensed physician or other healthcare professional licensed, qualified, and eligible to order breast prostheses must prescribe the items you are ordering. Dilettante Exclusively Yours will provide you with all necessary documentation to assist you in obtaining partial Medicare reimbursement upon your order.Dilettante Exclusively Yours will file your claim if Medicare is your primary and Medicare will partially reimburse you.

PRIVATE INSURANCE: If you are covered by private insurance, most major medical insurance policies cover mastectomy products according to their guidelines.We encourage you to call your insurance company to verify your benefits. Give them the procedure codes listed below and they will be able to give you information regarding what your policy allows, how much they pay, how many bras and breast forms you are eligible for each year.

SUPPLEMENTAL INSURANCE: If you have supplemented insurance, you may be entitled to additional reimbursement.