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Insurance Information - Are You Eligible?



Provincial Insurance plans may provide coverage on breast prosthesis after cancer, what many don’t know is that:

Most Private or Group Health Insurance policies cover mastectomy bras in Canada.   With over 2/3 of Canadians having some form of private health insurance – many of you are eligible for some type of refund!

As well, many of our clients have been able to claim other cancer related products from Gorgeous You including bathing suits, hats, wigs and breast forms.

To help you navigate the process here are some answers to frequently asked questions:

Will my insurance cover bras?

In are experience most private insurance companies in Canada cover your surgical bras and post-mastectomy bras, or at least some portion of the purchase.

How many bras will be covered?

That depends on your policy.  Most private insurance plans typically allow between 2-6 bras per year or the equivalent value.  This will vary by provider and medical need. It is always best to have whoever is running your claim ask about restrictions of your coverage.

How many years will my bras be covered?

What we have found with most providers is that restrictions are not based on WHEN your mastectomy was, but by use and need of a mastectomy bra. I am 10+ years out from my surgery and can still claim my bras.

What other products may be covered?

We have seen a wide range of coverage plans.  Some more typical products covered outside of bras are pocketed swimsuits, hats and wigs.  We have had customers with insurance plans that top-up silicone prosthesis purchases and cover the costs of wigs and mastectomy garments.  Other insurance companies allow their plan members to claim up to a specified number of medically related products, no matter the cost, on an annual basis.  Other women have told us that their insurance provider, with a prescription from a medical doctor, will cover the cost of hats and wigs due to hair loss and moisture-wicking pajamas due to medically induced menopause. And the list goes on. 

What should I do next?

 PLEASE, PLEASE, PLEASE CONTACT YOUR INSURANCE PROVIDER!!!!  If you have private insurance coverage, it is absolutely worth your time to make the call.  From our experience, most private insurance plans appear to assist cancer patients in some fashion BUT they vary wildly in what they cover, the manner in which they cover it and the items deemed eligible for coverage.  You may be surprised to find that you have coverage that you were not aware of or that your policy allows you to purchase new or replacement products more often than you thought.

Can I get a quote before purchase to submit to ensure I have coverage?

Yes!  We would be happy to provide you with a quotation which you can submit to your insurance company prior to making a purchase in order to ensure you will be covered. Please contact us for a quotation.

We are here to help you!

ALL insurance companies require receipts and in most cases, they are somewhat particular in form and format of which they are submitted.  We will get out a personalized receipt to you quickly with exactly the information your provider requests.  To avoid frustration and an overly lengthy process, be sure to check with your insurance provider to determine the specifics of your coverage and what they require by way of receipt and receipt details.

We want make sure you get the help you need! If you have any questions at all, please contact us at info@gorgeousyou.ca or give us a call 905-717-0030.

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