Although we strive to make our bras accessible to all, the bottom line is that AnaOno is out-of-network with many insurance companies. This means it is best to assume your bra may not be covered without additional deductibles and co-pay fees by your provider.  

If you want to double-check, the best step is to call your provider directly before you buy. You may be eligible for qualifying L8000 pocketed mastectomy bras or L8030 silicone breast forms, but coverage varies by insurer, state, plan type, diagnosis, and documentation requirements.

AnaOno does not bill insurance directly and cannot guarantee reimbursement. 

We suggest asking:

• Is HCPCS code L8000 (mastectomy bra) or L8030 (silicone breast form) covered under my plan?
• Do I need a prescription?
• Do I need prior authorization?
• Can I purchase from AnaOno and submit reimbursement myself?
• Is AnaOno (NPI #1740078443) considered out-of-network?
• How many bras are covered each year?
• What documents must accompany my claim?
• What is my reimbursement amount?
• What is the claim submission deadline?
• What is the appeal process if my claim is denied?

Coverage usually isn’t based on when your mastectomy was, but on your current medical need for and use of a mastectomy bra or breast form. You may need a prescription from your doctor for an L8000 mastectomy bra (and a breast form, if you’d like one). Call your provider to find out more.

Yes, you may be eligible — call your provider to confirm. If you are, your doctor or surgeon can write a prescription for an L8000 pocketed mastectomy bra.

You may still be eligible. Reconstruction isn’t always perfectly symmetrical, and a balance form or other breast prosthesis can help.

If you’re covered, most insurance companies cover roughly 4–6 bras per year. Orders can only be placed for the number of bras listed on your prescription (if no number is listed, it defaults to one). If you’d like more, you’ll need an updated prescription. Call your insurance or claims contact to confirm exactly how many your plan allows.

Many AnaOno styles are pocketed bras that meet the L8000 code. Browse our pocketed bras collection, or shop by surgery type to see your options.

Any doctor involved in your care can prescribe your mastectomy bras and breast forms. We suggest your breast surgeon or plastic surgeon, since they write these prescriptions often.

Ask that both your diagnosis code and the number of bras deemed medically necessary are written on the prescription. We recommend requesting at least 4 bras so you don’t have to return for another prescription right away — orders can only be placed for the number listed.

Once it’s submitted to your provider for processing, a prescription is typically valid for up to 90 days. You don’t have to commit all at once — order one bra to check size, fit, and style, then order more without needing a new prescription.

Requirements vary by insurer, so call yours to confirm. Most claims ask for some combination of a prescription from your physician, an itemized receipt, your order confirmation, a product description showing L8000/L8030 eligibility, diagnosis information if requested, and your insurer’s claim form.

Most denials come down to paperwork rather than true ineligibility. The most common reasons are a missing prescription, diagnosis code, or itemized receipt; prior authorization not obtained; an out-of-network or non-covered benefit; a missed filing deadline; quantity limits exceeded; or an insurer that requires purchase through a contracted DME supplier. To avoid missing paperwork, call your provider before you buy and ask exactly what your claim requires.

A denial isn’t always the end of the road — you may be able to appeal. Request the denial reason in writing, confirm all required documentation was submitted, ask your physician for supporting medical-necessity documentation, and submit your appeal within your insurer’s deadline.

It can. Each provider, plan, and coverage detail will vary based on your plan details. This could affect your out-of-pocket costs, coverage limitations, and additional fees collected by your insurance to process your claim. Working closely with your local mastectomy boutique is important to understanding how your benefits may work best for you. 

Mastectomy bras can be reimbursed through a flexible spending account (FSA), health savings account (HSA), or health reimbursement arrangement (HRA). We also offer FSA/HSA payments at checkout!

Insurance isn’t the only path, and you always have a next step. Depending on your situation, you may be able to use our Bra Assistance Program, FSA/HSA funds, or our nonprofit support programs.