The question is…
In the many years that I have been helping women who have undergone a mastectomy, the same questions are always asked. Below, I share these most frequently asked questions along with my answers.
Will my medical aid pay for the external breast prostheses and post-mastectomy bras?
Successful payments of claims will depend on what plan you are on and the funds available. Visit your medical aid’s website and carefully read the conditions of the plan you have taken out. Also, enquire if there are adequate funds available, and from which fund the claim will be paid. For instance, the external breast prostheses might be paid from the “Oncology fund” while the bras might be paid from the “Savings fund”. Enquire if there will be a co-payment, and, if so, what percentage it will be from the total claimed amount.
Where can I buy external breast prostheses and post-mastectomy bras?
It is recommended that you consult a trained professional with a registered practice, as the medical aid will only accept a claim if:
• The provider has a practice number.
• The products you purchase have a NAPPI code.
• The ICD10 code appears on the claim form.
Please note: Most medical aids also require a doctor’s motivational letter to accompany the claim when submitted.
And very important: The provider is obligated to inform you of the amount that is to be claimed before the service is rendered. You should also be provided with a detailed account within a reasonable period.
How long will the external breast prostheses last for?
Not all external breast prostheses are the same, so ask if it has a guarantee. All Naturalwear external breast prostheses have a two-year warranty. A two-year guarantee is preferable because most medical aids provide for external breast forms every two years.
Be calm, be informed, and don’t be scared to ask questions, but remember to always ask the right questions so that you will be informed with answers that will make your journey to recovery a little easier.
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