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).  They 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 claimant or the supplier of the product.
Who can claim this service payment?
You may claim for 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.
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
P O Box 5013
Wellington 6145
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