Medicare

As of June 2013, Nell’s is able to bill Medicare for items which maybe covered under their plan.  Contact us to set up an appointment, items you will need to bring to your consultation includes:

  • Current Prescription for billable items *
  • Current insurance card (s)
  • Complete a recent Face-to-Face with your prescribing Physician
Medicare Allowable items include:
  • One Silicone Breast Form – Every 2 years (2 forms for bilateral surgery)
OR
  • One Foam Breast  Form – Every 6 months (2 forms for bilateral surgery)
  AND
  • Mastectomy Bras are reimbursed as deemed Reasonable and Necessary
*Medicare is Primary:
In order to qualify for partial Medicare reimbursement, a licensed physician or other licensed healthcare professional, qualified, and eligible to order breast prostheses must prescribe the items you are ordering.   You also must complete a Face-to-Face meeting with your prescribing physician within 6 months of purchasing the items.
Nell’s will file your claim if Medicare is your Primary Medicare insurance and Medicare will partially reimburse you; however Nell’s may not be able to file claimed for Medicare Advantage Plans (i.e. HMO, AARP, Network Health, etc)
Supplemental Insurance: 
If you have supplemental Insurance, you may be entitled to additional reimbursement.
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