INSURANCE AND BILLING
We Handle the Insurance Billing, So You Don't Have To
We are an ABC (American Board of Certification) accredited facility, we accept most insurance assignments, and we are in network with most insurers. We work directly with your insurance for billing and payment, so there is little or no out-of-pocket expense for most customers - though you may still be responsible for deductibles and coinsurance.
Recommended Customer Flow
Contact Us
Tell the team what product or service you need help with, and confirm we are in network with your insurance.
Bring Your Prescription
All insurances require a valid prescription on file from your Primary Care Physician or Oncologist. Signed prescriptions are valid for one year - call us if you are unsure whether one is on file.
We Bill Your Insurance
We work with your insurance for billing and payment, so there is little or no out-of-pocket expense in most cases.
Get Fitted
A certified fitter helps you select an appropriate product.
Common Insurance Questions
Coverage varies by insurer and plan, so these are general answers. Call us and we will verify your specific benefits before your appointment.
Do you accept my insurance?
We accept most insurance assignments and are in network with most insurers. If there is ever a question about your specific plan, call us and we will verify it before your appointment.
Do I need a prescription?
Yes. All insurances require a valid prescription on file, from your Primary Care Physician or Oncologist. Signed prescriptions are valid for one year.
Will I have an out-of-pocket cost?
We accept most insurance assignments, so out-of-pocket expense is little or none in most cases - though you may still be responsible for deductibles and coinsurance.
How many products may be covered?
Medicare and most Medicare Advantage plans allow 3 mastectomy bras every 3 months. Medicaid plans allow 2 bras every 180 days. Commercial insurance coverage varies - call us and we will verify your specific benefit.
How often can eligible products be replaced?
Most Medicare, Medicaid, and commercial plans allow a new silicone prosthesis every 2 years. If you have had a significant weight change, you may be eligible to replace your prosthesis sooner with clinical notes from your Primary Care Physician or Oncologist.
What should I bring?
Bring your valid prescription (from your Primary Care Physician or Oncologist, valid for one year) and your insurance information. If you are not sure whether we already have a prescription on file, call us and we will check.