Bill to Provide Medicare Coverage of Custom Breast Prostheses Reintroduced in Congress

Published in Government Relations on July 25, 2023

U.S. Representatives Judy Chu (D-CA) and Mariannette Miller-Meeks (R-IA) have reintroduced the bipartisan H.R. 4779: Breast Cancer Patient Equity Act, which would provide Medicare coverage of custom breast prostheses to breast cancer survivors. Since most private insurance companies follow Medicare coverage standards, passage of this legislation will allow hundreds of thousands of women each year to choose a custom prosthesis after mastectomy.  

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

Medicare covers most other post-mastectomy treatment options and other custom prosthetic devices; however, custom breast prosthesis is the only prosthetic device not covered by Medicare. Senator Duckworth noted how the new legislation is a step toward achieving health equity for older women and women of color. As breast cancer survival rates increase, so should Medicare coverage of treatment options, Murkowski added.  

“Breast cancer survivors who have undergone a mastectomy deserve to have a full range of affordable reconstructive options,” said Rep. Chu. “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.”

“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,” said Rep. Miller-Meeks. “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.”

For more information and to take action, visit www.peopleforqualitycare.org/letherdecide.  

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