Your Complete Guide to Mastectomy Bra Fitting and Provincial Funding
As Amoena Certified Mastectomy Fitters, our goal is to ensure you feel secure, comfortable, and beautiful after surgery - without the added financial stress. This comprehensive guide covers why a certified fitting is essential and how to access available provincial funding and private insurance coverage across Canada.
Why a Certified Mastectomy Fitting is Essential
The process of finding the right post-mastectomy garment is highly personal and requires specialized knowledge that extends far beyond standard bra sizing.
What is a Certified Mastectomy Fitter (CMF)?
A Certified Mastectomy Fitter is a trained health professional. They have completed education and practical experience in the proper fitting of external breast prostheses (forms), post-surgical compression wear, and pocketed mastectomy bras.
Our certification means we are trained to assess your unique post-operative needs, including scar tissue and volume needs. This ensures:
- Optimal Comfort: The bra must not irritate sensitive skin or surgical areas.
- Correct Posture: Proper weight balance to prevent back, neck, and shoulder strain.
- A Natural Shape: We help restore balance and confidence under clothing.
- Secure Fit: The pockets securely hold your breast form during activity.
Your Fitting Options
We offer flexible, expert consultation to meet you where you are in your recovery journey:
- Virtual Certified Fitting: A private video consultation with our CMF. We guide you through taking your own measurements and recommend the perfect garments and size. This is perfect for clients across Canada seeking convenience and privacy.
- In-Person Certified Fitting (Barrie, ON): A one-on-one session in our dedicated fitting room. This is the most recommended option for initial breast form fittings, allowing for hands-on adjustments.
Comprehensive Guide to Provincial Funding and Reimbursement
In Canada, external breast prostheses (forms) are often covered by provincial programs. Mastectomy bras are usually covered by private or extended health insurance.
Important: We will help you complete the required sections of these forms, but final eligibility is determined by the relevant Provincial Program or your Private Insurer.
Provincial Funding for Breast Forms (Prostheses)
The table below provides a summary of the maximum coverage for breast prostheses and the required application forms for major provincial programs. Coverage typically renews every 2 years, unless otherwise noted.
| Province/Program | Coverage Details (Max) | Customer Action & Forms/Links |
|---|---|---|
| Ontario (ADP) | Grant ofup to $195 per side for a full prosthesis. |
Form Required: We can provide the ADP "Application for Breast Prosthesis Grant" form during your fitting. You submit the form and receipt for reimbursement. Download the ADP Form 4392-67E |
| Quebec (RAMQ) | Reimbursement of up to $525 for a full breastform. |
Action: You must purchase from a Quebec business and submit the reimbursement application. RAMQ External Breastforms Program Page (Online Application) |
| British Columbia (PharmaCare) | Coverage of up to $450 for a full breast prosthesis. |
Action: Check your Fair PharmaCare deductible status. BC PharmaCare Forms Page (Relevant forms: HLTH 5415/5417) |
| Nova Scotia (MSI) | Rebate of up to $300 for a prosthesis. Additional income-based funding available. |
Form Required: You complete and submit this rebate application with your receipt and physician referral. Download the MSI Rebate Application Form |
| Manitoba (MBPP) | Coverage for a prosthesis and $70 for one bra. |
Action: This is generally administered through CancerCare Manitoba by approved vendors (check for current policies). Manitoba Breast Prosthesis Program Policy Page |
| Alberta (AADL) | Cost-share program (client pays up to 25%). Coverage for forms and some supplies. |
Action: Requires a prescription and assessment by a registered AADL Authorizer . AADL Breast Prostheses Program Page |
| Other Provinces (SK, NB, NL, PEI, Territories) | Varies (Contact us for details). Limited direct programs for breast forms. | Action: Private insurance is the primary coverage source. Specific low-income assistance may be available. |
Funding for Mastectomy Bras and Additional Prosthesis Costs
The cost of your mastectomy bra(s) and any remaining cost of the breast form (beyond the provincial grant) is typically covered by private or extended health insurance. Note that Manitoba is a rare exception with specific bra coverage.
Your 3 Steps to Private Insurance Coverage:
- Get a Prescription: Request a prescription from your doctor or surgeon. It must clearly state the need for "Mastectomy Bras," "Post-Surgical Compression Bras," or "External Breast Prosthesis."
- Purchase with Detailed Receipt: Purchase your items from Naturally You. We provide detailed receipts listing the supplier, our CMF details, the product name, and its medical purpose.
- Submit Your Claim: Send the claim form, your prescription, and your detailed receipt to your private insurance provider for reimbursement.
Frequently Asked Questions
- How often can I get a new prosthesis?
- Provincial programs and most private insurance plans allow for coverage of a new breast prosthesis every two years (24 months).
- Are compression bras covered?
- Yes, post-surgical or compression bras are typically covered by private insurance if prescribed by a physician as necessary for your post-op recovery.
- Do I need an appointment?
- Yes. For both virtual and in-person fittings, appointments are required. This ensures a Certified Mastectomy Fitter is dedicated to your needs.