As we all know, breast cancer — along with many other health issues — can be costly and wreak havoc on finances. When items that are necessities, like post-surgical bras, can be covered by insurance, it is important for women to have all the information to use the benefit so they have one less thing to worry about.
Most insurance companies allow two bras to be covered (one to wash, one to wear) for a breast cancer related surgery using the L8015 insurance code, which is defined as a post-surgical bra (which means it needs to come with pockets and a set of puffs to qualify).
Many times, bras are not provided at hospitals or they leave the patient wanting a better fit or more comfort, so it is good to get bras beforehand to ensure you are going to be happy with the bra you are recovering in post-surgery. There are a couple of ways you can get your bras ahead of time.
- You will need to have a prescription from your nurse or doctor.
- You can go to a local fitting shop/hospital shop that can bill your insurance for you. It would be best to call ahead to schedule an appointment and make sure they can approve your insurance.
- Order your bras online and submit your receipts to insurance. Please make sure you check with your insurance company for details such as how many post-surgical bras you can get and what your dollar limit is per bra.
We talked with Kimberly Robinson, owner of Underneath It All in Eden Prairie, MN, a local fitting shop that carries our post-surgical bras to get some additional tips and information. Bras like our Larissa Bra are carried at shops like these because they include pockets for puffs and drain management, often needed in the first stages of recovery after surgery.
She also shared with us that insurance companies cover anywhere from 2-12 mastectomy bras each year under the L8000 code, which is defined as a bra with pockets (for forms).
Lymphedema sleeves are now being covered by Medicare, Medicaid, and some — but not all — commercial insurance companies. Breast forms are typically covered for 1 per side every two years. Wigs are now being covered under some insurance as well.
If you are having another type of surgery, one that is non breast cancer related, you can use your FSA/HSA card to purchase a qualifying bra for your recovery. For example, our Shirl Bra, which was designed with heart surgery in mind, is FSA/HSA approved through https://sig-is.org/ as is our Serena Bra, which is ideal for post-surgical recovery without drains. In fact, all three of our bras are approved by sig-is. If there are other products you want to check, you can do a search on their site.
We hope this helps you better understand how to access post-surgical bras by using insurance or your HSA/FSA account. If you have any questions, we are happy to help, and if we don't know the answer, we'll try and point you in the right direction!