Legislative Update

Breast Cancer Patient Equity Act

The Breast Cancer Patient Equity Act would require Medicare to recognize custom breast prostheses as an eligible benefit after mastectomy surgery.  For most women, current options are reconstructive surgery or off-the-shelf prosthesis.  We know some women are not candidates for reconstructive surgery due to a variety of medical reasons, and others choose not to undergo reconstructive surgery. For many women an off-the-shelf prosthetic that fits inside a pocketed mastectomy bra is the best option; however, there are limitations.  Some of those considerations are:

  • Chest wall contour:  if a patient doesn’t have a flat chest wall after a mastectomy an off-the-shelf prosthesis may not fit well
  • Matching skin tone:  off-the-shelf prosthetics usually only come in 2 skin colors.  Custom breast prosthesis come in more than 36 skin colors
  • Finding symmetry following a unilateral mastectomy (one breast removed) is a challenge.  A custom prosthetic can be created to match her profile to keep symmetry.  Finding an off-the-shelf prosthetic to match an existing breast is difficult. 

Allowing women to choose the outcome that best meets their needs will be beneficial for the road to recovery and moving forward.  The Breast Cancer Patient Equity Act is about making sure women have the appropriate choices after mastectomy surgery.  Statistics indicate one in eight women will be diagnosed with breast cancer in her lifetime.  Nobody thinks it will be them and nobody knows what option they may choose until faced with a diagnosis.  

The breast is one of the few body parts not covered by Medicare as a custom replacement – we should be able to do better.  Many private insurance companies follow Medicare guidelines, that’s why this legislation is so important.  Women of all ages and insurance coverages will be impacted.


The Let Her Decide Campaign seeks to pass legislation for Medicare to cover custom breast prostheses. Since many health insurance companies follow Medicare guidelines, it's important for women everywhere to pass this legislation so you can be allowed to choose the solution that works best for you. Visit letherdecide.org to learn more on why it is so important to pass this legislation.

Need help or have questions? Call Essentially Women at 800-988-4484 or email us at essentiallywomen@vgm.com

H.R. 4034 - Cranial Prothesis/Wig Coverage

There are many reasons for medical hair loss.  Some of the most common reasons include cancer treatment, alopecia areata (an autoimmune disease that attacks hair follicles) and thyroid disease.   For many patients experiencing medical hair loss, their hair will grow back; however, some will have intermittent or permanent hair loss.  This unpredictability adds to the stress for those who experience hair loss and how long they will wait for their hair to grow back.   

Please reach out to your congressional leaders today asking them to support H.R. 4034  allowing for coverage for wigs and cranial prostheses.