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Prosthetics Prior to Reconstruction - Insurance?

momgoose Member Posts: 71
edited February 2023 in Breast Reconstruction

I had a DMX on Jan 4th with TE's. Earlier this week, I lost both TE's to necrotic wound edges and possible infections, so it will be 6 months before we can even attempt to begin reconstruction again. I'm not flat...I'm concave at this point! My question is, I know insurance will pay for prosthetics or reconstruction, but does anyone know if they pay for prosthetics while waiting for a delayed reconstruction? I know it's only 6 -10 months or so, but we're heading into spring and summer and there's no way to hide the massacre that is my chest at the moment!

Anyone been there, done that with advice?



  • lw422
    lw422 Member Posts: 1,403

    Momgoose--they will probably pay with no problem. Since most of us all have different insurance coverage, the only way to know for certain is to contact your insurance company. In the meantime, you can get some soft crocheted "knitted knockers" for free from this organization...

  • grace248
    grace248 Member Posts: 7

    Christina - I'm sorry I can't answer your question regarding insurance coverage. But if it is helpful, I had a DMX not quite 2 weeks ago. I am already able to comfortably wear the breast forms in a mastectomy bra that they sell online at The Busted Tank. They are inexpensive and seem to be a good solution for me until I am at the point that I can try out one of the prescription type prosthetics. I also ordered and received very quickly the knitted knockers mentioned by lw422 above.

  • momgoose
    momgoose Member Posts: 71

    lw422 and grace 248

    Thank you for your replies. I do have some inexpensive foam prosthetics from AnaOno and Athleta, I just wondered if there would be something more well-fitted that was available through insurance. I was under the impression that it was an either-or situation with insurance - either reconstruction was paid or prosthetics, but then I ran into this scenario and thought about those who delay reconstruction and wondered if I misunderstood. I guess I will call the insurance co. and see what's what!