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Medicare Coverage – Cosmetic Surgery: Does Medicare cover Cosmetic Surgery after a Mastectomy

Does Medicare cover cosmetic surgery after having a Mastectomy? The answer is yes, they do cover breast prostheses after a mastectomy. A breast prosthesis is an artificial breast form. It gives a breast a more natural shape after a mastectomy or breast-conserving surgery.
Medicare Part B covers external breast prostheses (including a post-surgical bra) after a mastectomy. Medicare also covers surgically implanted breast prostheses after a mastectomy. Medicare Part A (hospital benefit) covers the surgery if it takes place in an inpatient setting. Part B covers the surgery if it takes place in an outpatient setting.
All people with Medicare Part A and/or Part B are covered.
You pay 20% of the Medicare-approved amount for the doctor's services and the external breast prostheses. The Part B deductible applies. For surgeries to implant breast prostheses in a hospital inpatient setting, you pay the Part A hospital care costs.

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