Yes, Medicare covers a breast prosthesis after a mastectomy. Medicare Part B pays for an external breast prosthesis, including a special mastectomy bra, as a prosthetic device, and it covers 80% of the approved amount once you've met the Part B deductible. Whether you've had the surgery yourself or you're helping someone who has, here's what Medicare pays for and what it leaves to you.Centers for Medicare & Medicaid Services. (n.d.). Breast Prosthesis Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/breast-prostheses
In This Guide
- Key Takeaways
- What Medicare Covers for a Breast Prosthesis After a Mastectomy
- What It Costs You
- Implanted vs. External Breast Prosthesis: Which Part of Medicare Pays
- Frequently Asked Questions
- Learn More
What Medicare Covers for a Breast Prosthesis After a Mastectomy
Let's start with the part most people are searching for. If you've had a mastectomy, Medicare Part B covers an external breast prosthesis, which is the breast form you wear, and it also covers a post-surgical mastectomy bra to hold it in place. Medicare treats both as prosthetic devices, the same category it uses for an artificial limb.Centers for Medicare & Medicaid Services. (n.d.). Breast Prosthesis Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/breast-prostheses
That coverage is national. The Centers for Medicare and Medicaid Services (CMS), the federal agency that runs Medicare, puts it plainly in its provider guidance: Medicare covers a breast prosthesis for a patient who has had a mastectomy.Centers for Medicare & Medicaid Services. (n.d.). Breast Prosthesis Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/breast-prostheses So this isn't a state-by-state thing or something buried in the fine print of one plan. It's a standard Part B benefit.
The benefit also reaches the professional side of getting fitted. When Medicare figures your cost share, it counts both the external prosthesis and the related doctor's services, so the appointment where you're measured and fitted is part of the same Part B benefit, not a separate charge you're on your own for.Centers for Medicare & Medicaid Services. (n.d.). Breast Prosthesis Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/breast-prostheses
A quick note on the two things people mix up. An external prosthesis sits outside your body, in your bra. A surgically implanted prosthesis is placed during reconstruction surgery. Medicare covers both, but they're paid for in different ways, and we'll get to the implanted one further down.
What It Costs You
So here's how the money actually works for the external prosthesis and mastectomy bra.
Medicare pays 80% of the Medicare-approved amount, and you pay the other 20%. That 20% applies to both the prosthesis itself and the related doctor's services, and it kicks in only after you've met your Part B deductible for the year.Centers for Medicare & Medicaid Services. (n.d.). Breast Prosthesis Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/breast-prostheses In 2026, that deductible is $283.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jul 23, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles Once you've paid it, whether on this or on any other Part B service earlier in the year, you don't pay it again.
Put together, a typical year looks like this: you cover the first $283 of Part B costs, then you're responsible for 20% of the approved amount on the breast form and the fitting, and Medicare covers the remaining 80%.Centers for Medicare & Medicaid Services. (n.d.). Breast Prosthesis Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/breast-prostheses,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jul 23, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
If you also carry a Medigap supplement policy, it's generally designed to help with the coinsurance and deductibles that Original Medicare leaves you to pay, so your out-of-pocket share for the prosthesis may be smaller or nothing at all. How much it covers depends on which Medigap plan you have.
Implanted vs. External Breast Prosthesis: Which Part of Medicare Pays
This is the distinction that trips people up, and it comes down to where the prosthesis goes and where the procedure happens. Here's how the three paths line up:
| Prosthesis type | Where it happens | Which part pays |
|---|---|---|
| External breast form and mastectomy bra | Worn outside the body | Part B |
| Surgically implanted, inpatient | You're admitted to the hospital | Part A |
| Surgically implanted, outpatient | Done as outpatient surgery | Part B |
The external prosthesis and mastectomy bra, the ones you take on and off, are always a Part B benefit, as we covered above.Centers for Medicare & Medicaid Services. (n.d.). Breast Prosthesis Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/breast-prostheses
A surgically implanted prosthesis is different, because it's part of an operation. When that surgery is done during an inpatient hospital stay, meaning you're formally admitted, Medicare Part A (Hospital Insurance) is what covers the implanted prosthesis. When the same surgery is done in an outpatient setting, Part B covers it instead.Centers for Medicare & Medicaid Services. (n.d.). Breast Prosthesis Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/breast-prostheses
Why does that matter to you? Because Part A and Part B have different deductibles and different cost-sharing, so whether your reconstruction is billed as inpatient or outpatient changes what you'll owe. If reconstruction is on your radar, it's worth asking the hospital's billing office ahead of time which way your surgery will be classified, since that single detail decides which deductible applies.
None of this is either-or, by the way. Plenty of women use an external breast form for a while and consider surgical reconstruction later, or choose one and never the other. Medicare's coverage sits behind whichever path you and your doctor land on, so the decision can stay a medical and personal one rather than a coverage one.
Frequently Asked Questions
Does Medicare cover a mastectomy bra?
Yes. Medicare Part B covers a post-surgical mastectomy bra, the kind made to hold a breast form, as a prosthetic device for someone who has had a mastectomy. You pay 20% of the Medicare-approved amount after your Part B deductible, and Medicare pays the other 80%.Centers for Medicare & Medicaid Services. (n.d.). Breast Prosthesis Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/breast-prostheses
How much does a breast prosthesis cost with Medicare?
For the external prosthesis, you pay 20% of the Medicare-approved amount once you've met the Part B deductible, which is $283 in 2026. Medicare covers the remaining 80%.Centers for Medicare & Medicaid Services. (n.d.). Breast Prosthesis Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/breast-prostheses,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jul 23, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles If you have a Medigap policy, it may pick up part or all of that 20% and the deductible.
Does Medicare cover breast reconstruction after a mastectomy?
When it involves a surgically implanted prosthesis, yes, and the coverage follows where the surgery happens. If you're admitted as an inpatient, Part A covers the implanted prosthesis; if the procedure is done as an outpatient, Part B covers it. The Part A and Part B cost-sharing rules are different, so ask how your surgery will be billed.
Does Medicare pay for the fitting appointment?
Yes. When Medicare calculates what you owe for an external breast prosthesis, it includes the related doctor's services alongside the device itself, so the fitting is covered on the same terms: 20% coinsurance from you after the Part B deductible, and 80% from Medicare.Centers for Medicare & Medicaid Services. (n.d.). Breast Prosthesis Coverage. medicare.gov. Retrieved Jul 17, 2026, from https://www.medicare.gov/coverage/breast-prostheses
Learn More
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