Before you choose or change insurance carriers make sure you are covered for prosthesis(es). Much to my surprise and frustration, I recently found out my current carrier does not cover the prostheses company I have been using since my bilateral mastectomy over four years ago.
Each year, with my former insurance provider, I was entitled to four bras; every two years I was entitled to replace my prostheses. Without coverage through my current insurer, the cost to me for bras and prostheses would be hundreds of dollars.
My choices are limited. I can continue to see my prostheses company, and be subject to my insurance carrier’s out of network rate; I can go to an in-network provider. I asked my insurance company for the names of prostheses providers in Manhattan, NYC. I was given the name of two providers that are in network in my plan. In all of Manhattan, where there are dozens and dozens of companies with certified fitters on staff and carrying name brand bras and prostheses, they only have two providers in their plan! Before you decide that I have some rinky-dink insurance carrier, let me assure you it is one of the top five insurance carriers in the nation!
I contacted the first company. They do not have a certified fitter in Manhattan. If I need to be fitted for a bra, the nearest store with a fitter on-site, is an hour subway ride away! The second provider is not a store or shop, but one person operating out of her home. She does fittings, but then you order from a catalog.
Getting a breast prosthesis(es) that is a good fit depends on having a certified fitter and being fitted in an accredited shop. A fitter can tell you what your insurance covers initially, and what you are entitled to annually thereafter. A fitter will speak with you about what materials the breast prosthesis(es) come in and try all to see what is the most comfortable, stays in place and is a good balance with your own remaining breast.
It is critical to feel good about how you look; a good fitting prosthesis is key to feeling confident about your personal appearance.
I find it ironic that my insurance carrier covers breast reconstruction at a reimbursement rate that would keep me and several other women, who did not choose reconstruction, in bras and prostheses for the rest of our lives. I support the right of every woman to choose reconstruction; I am happy it is the law for women to be told they have this option. However, for some women, reconstruction is not always an option, or is not something they are comfortable choosing.
