Breast Prosthesis & Post-Mastectomy Bra Funding: What You're Entitled To in Australia

You May Be Eligible: A Guide to Funding for Breast Prostheses and Post-Mastectomy Bras in Australia
At Leila O’Toole, we understand that the journey after breast surgery can feel overwhelming. One challenge many women face is understanding what financial support is available for essential items like breast prostheses and post-mastectomy bras.
You’re not alone — many women in Australia are unaware they’re eligible for funding or don’t know how to access it. This blog aims to simplify the process and help you get the support you’re entitled to.


1. Medicare’s External Breast Prostheses Reimbursement Program
Medicare provides a rebate of up to $400 every two years for new or replacement external breast prostheses.
Who’s eligible?

• Women who have had a mastectomy (full or partial) due to breast cancer.
• Must be enrolled in Medicare.

How to claim:

• Purchase your prosthesis from an approved provider like Leila O’Toole.
• Keep your original receipt.
• Fill out the Application Form (MS001) from Services Australia.
• Submit it via Medicare online, in person, or via post.

👉 Tip: We can claim it for you on your behalf. You can claim after every two-year period or once a new prosthesis is needed within that time frame.


2. ENABLE NSW (for residents of NSW only)
ENABLE NSW offers funding for eligible NSW residents through its Breast Prosthesis Service.
Eligibility includes:

• Holding a Pensioner Concession Card or Health Care Card.
• Permanent resident of NSW.
• Clinically assessed as needing a breast prosthesis due to surgery.

Covers:

• One prosthesis every two years.
• Some programs may also assist with post-surgical bras or compression garments.

To apply, a health professional may need to help you complete the ENABLE application form.


3. Department of Veterans' Affairs (DVA)
If you’re a veteran or dependent with a DVA Gold or White Card, you may be eligible for provision and replacement of:

• External breast prostheses
• Mastectomy bras
• Compression garments

How to claim:

• Speak with your GP or specialist.
• Submit a request through DVA-approved providers like Leila O’Toole.
• No out-of-pocket cost if approved under DVA entitlements.

4. Private Health Insurance: Are You Covered?
If you have private health insurance, you may be eligible for rebates or full coverage for prostheses and post-mastectomy bras, depending on your extras or hospital cover.
Major Australian funds that often cover these include:

• HCF
• BUPA
• Medibank Private
• nib
• AHM
• Teachers Health
• HBF
• CBHS

How to claim:

• Contact your provider to check if compression bras, pocketed bras, or external breast prostheses are included in your cover.
• Provide an itemised receipt from Leila O'Toole to process the claim.

👉 Tip: Ask your provider if a doctor’s referral or prescription is needed to claim certain items.


Why This Matters
Having access to the right prosthesis and supportive post-surgical bras is vital not just for physical comfort, but also for emotional healing and confidence.
Unfortunately, navigating funding can be confusing — but we’re here to help. At Leila O’Toole, we provide:

• Assistance with receipts for Medicare and private health claims
• Guidance with DVA and ENABLE NSW processes
• Compassionate, expert fittings in-store or via virtual consults

Need Help With a Claim? Contact Us Today
We want to ensure no woman goes without the care she deserves due to lack of awareness or confusion around funding.
📞 Call us @ 0403095371 or 📧 email us [email protected] and our team will walk you through the steps — because getting the support you need shouldn't be hard.
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