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H.R. 4779 Would Provide Medicare Coverage for Breast Prostheses

July 27, 2023 by Laurie Watanabe

A new bill in the U.S. House of Representatives would provide Medicare coverage for breast prostheses for breast cancer survivors.

According to a news announcement on July 25, Essentially Women said passage of the bill — introduced by Rep. Judy Chu (D-Calif.) and Marianette Miller-Meeks (R-Iowa) — could also have ripple effects. “Since most private insurance companies follow Medicare coverage standards, passage of this legislation would allow hundreds of thousands of women each year to choose a custom prosthesis after a mastectomy,” the announcement said.

The bill is known as the Breast Cancer Patient Equity Act.

Nikki Jensen, VP of Essentially Women, said in the announcement, “This is great step forward in our efforts to expand access to life-changing healthcare for breast cancer survivors. We ask that anyone affected by breast cancer, or anyone who just feels that this is the right thing to do, to please contact their elected officials and show support for the Breast Cancer Patient Equity Act.”

Essentially Women pointed out that while Medicare covers “many other post-mastectomy treatment options and other custom prosthetic devices,” the organization added, “Custom breast prosthesis is the only prosthetic device not covered by Medicare.”

Miller-Meeks said in the announcement, “During such fragile times when women are dealing with the stress and toll of invasive breast cancer, line items of their insurance coverage are the furthest things from their minds. The Breast Cancer Patient Equity Act takes away the burden of calculating the coverage for custom prosthetics and gives access to higher quality implants for patients diagnosed with invasive breast cancer that undergo a mastectomy, regardless of their income.”

Chu added, “Breast cancer survivors who have undergone a mastectomy deserve to have a full range of affordable reconstructive options. There are many reasons why breast cancer patients choose not to have reconstructive surgery, and Medicare should not be limiting reasonable options that allow women to feel comfortable after fighting cancer. I’m grateful to be able to work on this bipartisan bill, and I hope we can pass it quickly so cancer survivors can finally have complete freedom of choice.”

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