Ministry of Health

Breast Care Essentials is an approved Ministry of Health provider

Your Ministry of Health funding balance is valid for you to use during a four-year period until your next allocation.

Your ‘anniversary date’ is the date of your first fitting. Every four years on that date you will be allocated another funding.

We can check your funding at any time, on your behalf with your approval.

What you need to know about breast prosthesis service payments

What is the breast prosthesis service payment?

It is a payment to people who have undergone a partial or full mastectomy, either unilateral or bilateral, and/or have undergone a lumpectomy, have congenital needs, or have undergone reconstructive surgery, as specified by a specialist or general practitioner (GP).

The payments are to reduce the cost of purchasing breast prosthesis, or prostheses, and other related products.

The Ministry of Health will pay this service payment to either the claimant or the supplier of the product.

Who can claim this service payment?

You may claim this service payment if:

You are a New Zealand citizen or are ordinarily resident in New Zealand; and
Your specialist or GP gives you a current medical certificate with your NHI number and details of your need for a breast prosthesis or prostheses.

What can I use the service payment for?

The service payment is available to cover the cost of the following items only:

breast prosthesis or breast forms (these may include standard breast forms, swim for, foam filler, shell prosthesis, and lumpectomy shells).
special bras to hold the breast prosthesis or breast forms
surgical bras and normal bras
modifications to bras to hold a prosthesis or breast form
prosthetic nipples.

How much can I claim?

Your entitlement is $613.33 incl GST per side, for a four-year period.

You may claim any amount up to the total amount of $616.33 (or $1226.66 incl GST for bilateral) at any time during the four-year entitlement period.

Note: The entitlement period begins on the date you make your first purchase from a supplier and ends four years from this date.

In addition to this:

You may apply to the Ministry of Health for an additional entitlement if your existing entitlement is insufficient because either:

You are under 18 and your GP or specialist considers that your growth is incomplete and your prosthesis or prostheses needs to be replaced regularly; or
You have lost a reconstructed breast due to infection after reconstructive surgery and need a replacement prosthesis or prostheses.

Requests for additional entitlements should be sent to:

Disability Services Directorate
Ministry of Health
PO Box 5013
Wellington 6145