Mastectomy bras can be beautiful and look the same as any other bra you might buy in a lingerie department. One of the designers I worked with had an impressive degree from the New York Fashion Institute of Technology. Designing a bra is an art and a science considering they usually have between 20 to 30 components! Bras, mastectomy or non-mastectomy, are priced depending on their ‘parts’ and features, fabrics, laces, trims, straps, seamed cups or seamless, etc.
Of course, designer labels have a premium price because of workmanship, laces, embroidery and embellishments and because they are ”designer” bras. When I worked in luxury lingerie, our bras were priced from $60 to $200. Some women spend hundreds of dollars a months on their hair, their cell phones, and/or a $5 cup of coffee every day of the week BUT cannot come to terms with spending money on bras. YOU need a wardrobe of bras…for every occasion…and breasts are very needy! Do not deny yourself all the bras you had before breast cancer because you don’t have to. If insurance does not cover all the bras you want, then just buy them. If you only wear white and nude, buy some color now! Colors can almost be like a neutral but can make you feel so much better! And do NOT wear the same bra day after day after day…bras need a rest, just like you do, after you have had a hard day at work! Don’t kid yourself…the larger your breasts are, the harder your bra is working for you and your prosthesis.
This bra introduction might be the best time to mention I have fit from cup size A to J. There are some very large breasts out there (let’s not forget I have done mammograms on all sizes too) but breast cancer patients often have a reduction on the unaffected side when they need a unilateral mastectomy. And at my hospital based Boutique, in the Women’s Center building, we also fit nursing bras for the new moms and those bras went up to an M cup! SO, my point is that I have a very extensive background in fitting all types of breasts in all stages of their life!
Mastectomy bras need to have a wider bridge (or center front) and pockets to accommodate the prosthesis. Luckily, the mastectomy bra manufacturers offer hundreds of styles and colors to choose from. There are endless choices including post-op bras, leisure bras, classic styles (seamed cups that may include a side panel for added support), seamless ‘t-shirt’ bras, non-underwire, underwire, soft-wire, camisole bras, and sports bras.
The fit of your bra is critical in order to wear a prosthesis comfortably and correctly. I think we have all heard that the majority of women wear the wrong bra size. They usually wear a band that is too big and a cup that is too small. Between my professional experiences as a Mammographer, Certified Mastectomy Fitter, and Luxury Lingerie Stylist, I have seen a lot of breasts that do not fit into bras!
Women who think they are a C cup are often an E cup or larger. Let your Fitter fit you properly. Once you are fit with the proper size bra, your prosthesis should not weigh you down or be uncomfortable. Don’t forget, bras are like jeans…you have to try on many to get the right size and fit. And the bra you love and want just may not be the best fit for you and your prosthesis. Your Fitter should try several on you and help you understand what styles works best for you.
Post-op / Leisure Bra
When you are getting ready for radiation therapy there are specially made bras for you or if you have healed enough from your surgery to again wear a bra, wear something pretty!
These bras are usually designed with an easy front closure and high cotton content fabrics for a cozy, comfortable feel, that you can also wear during your leisure time. Available in the white, black and nude plus fun colors and patterns, they are the perfect bra to wear while you are undergoing radiation treatment or recovering from surgery. These post-op/leisure bras are considered part of your bra allowance by insurance. You will want several!
Your insurance allowance for bras may never be the number that you want or need for your lifestyle. Purchase extra bras to fill in your bra wardrobe and don’t get ‘stuck’ on what your insurance allows! You always paid for bras before breast cancer, so allow yourself to pay for additional bras that your insurance may not cover.
Let’s talk about Medicare: My unique perspective includes the buying side and selling side of breast care DME products, so listen up!
DME is a very complex industry. Medicare reimbursement varies from state to state and reimbursement to your dealer is predetermined by an annual fee schedule.
Here is a very simplified example of how this industry works: For businesses that file Medicare, the owner knows reimbursement for ANY bra is $35 (sometimes more and sometimes less, depending on your state), based on the Medicare fee schedule. Does she give you the bra that costs her $8 or the bra that costs her $18? Bras, with several embellishments, can often cost the dealer between $20 to $30.
When it comes to bras, a dealer will often forego profit in order to assure the perfect fit and make you happy. A financial loss on a bra decreases the profit of your breast form, but many dealers will accept losing money on bras.
Some dealers will tell you “this is what Medicare allows you to have.” You can visit another dealer or accept what your Fitter says and be willing to buy more bras from her. Medicare does allow you to purchase additional bras, but they insist the dealer fills out more paperwork. Like I said, do not get ‘stuck’ on only owning what your insurer says you can have. There is a world of bra choices out there so open up your wallet…you earned it and you deserve it!
Other payers (Blue Cross Blue Shield, Aetna, CIGNA, etc.) typically follow Medicare guidelines but may have their own. Reimbursement from these insurers is ‘all over the place’ depending on contracts with your DME and other reimbursement criteria. This gets way too complicated to discuss here, but I hope you are getting the message! If not, give me a call.
Think of it as the generic drug vs. the brand drug…insurance is often the driver of your product choices. Fitters are dedicated professionals who want to serve you and your needs. But they have to consider the business side of product choices.
It is important that you call your insurance company to find out your benefits and it helps to have the Medicare billing codes (link to booklet) when you call, since insurance companies often locate benefits with these codes. Your dealer will be checking your benefits, but you should know what your insurance coverage is and what it allows you to take home.
Please do not underestimate the power of a beautiful bra, breast form or shaper that can give a woman symmetry. A woman’s emotional satisfaction, of looking normal in her clothes, cannot be weighed or measured. Your local breast care boutique can be the patient’s best emotional support.
The patient is referred to support groups and other helpful organizations, so be sure the patient understands the product options for them and that insurance may cover most of them. A quick phone call to me can help a patient enormously. After conducting countless medical practice ‘lunch and learns’ and in-services, I completely understand that most practices do not have the resources to stay updated with the breast care product industry and related insurance benefits. I really want to help medical practices help patients!