Welcome to 2026: Medicare & Private Health Fund Claims at Leila O’Toole

As we welcome 2026, Leila O’Toole remains committed to providing expert, compassionate care for women seeking professional breast support services. This year, we want to begin by sharing clear, up‑to‑date information about Medicare rebates and private health fund claims, helping you understand what financial support may be available to you. Understanding your eligibility can make accessing essential care more affordable and stress‑free — and our team is here to guide you through every step.

Medicare Rebates for Breast Prostheses and Related Services Many women are eligible for Medicare rebates when purchasing an external breast prosthesis following breast surgery, including mastectomy or lumpectomy. What Medicare May Cover Under current Medicare guidelines, eligible clients may be able to claim a rebate for: External breast prostheses Replacement prostheses (subject to Medicare timeframes) Medicare rebates are subject to eligibility criteria, including: A valid Medicare card Eligibility under the relevant Medicare item number Supporting documentation such as a medical referral or prescription, if required While Medicare does not usually cover the full cost, the rebate can significantly reduce out‑of‑pocket expenses. At Leila O’Toole, we provide: Correct invoices and itemised receipts Guidance on how to submit your Medicare claim Clear explanations so you understand what is and isn’t claimable

Claiming Through Your Private Health Fund In addition to Medicare, many clients can also access private health insurance rebates for breast prostheses, post‑surgical garments, and specialised lingerie. Private Health Fund Rebates May Apply If You Have: Extras cover A policy that includes benefits for medical appliances or prostheses Private health fund rebates vary depending on: Your insurer Your level of cover Annual limits and waiting periods We recommend contacting your health fund directly to confirm: What items are covered How much you can claim Whether Medicare must be claimed first Our experienced team is happy to assist by explaining how Medicare and private health fund claims can work together when applicable.

Why Choose Leila O’Toole Leila O’Toole is a trusted provider of professional breast care, prosthesis fittings, and post‑surgical support. We pride ourselves on delivering care that is discreet, respectful, and tailored to your individual needs. When you book an appointment with us, you can expect: Private, one‑on‑one consultations Expert fitting for breast prostheses and supportive garments Knowledgeable guidance on Medicare and health fund claims A calm, supportive environment focused on your comfort and confidence

Frequently Asked Questions (FAQs)
Do I need a referral to claim through Medicare? In many cases, a medical referral or prescription from your doctor or specialist is required to claim a Medicare rebate for an external breast prosthesis. We recommend confirming this with your healthcare provider prior to your appointment. Can I claim both Medicare and my private health fund? Yes, many clients can claim through both Medicare and their private health fund, depending on their level of cover. Medicare is usually claimed first, followed by your private health insurer. How much will I get back from Medicare? The Medicare rebate amount is set by Medicare and may change over time. The rebate generally covers part of the cost rather than the full amount. Does Leila O’Toole submit claims on my behalf? We provide all necessary documentation and invoices to support your claim. Claims are typically submitted directly by the client to Medicare and/or their private health fund. What if I’m unsure about my eligibility? Our team is always happy to discuss your situation and provide general guidance to help you understand your options before you book.

Book Your Appointment for 2026 If you’re considering a breast prosthesis fitting, post‑surgical support, or specialised lingerie, now is the perfect time to prioritise your wellbeing. 📅 Appointments are open for 2026
💳 Medicare and private health fund claims may be available when eligible Contact Leila O’Toole today to book your appointment or to speak with our experienced team. We look forward to supporting you throughout 2026 and beyond.

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