How To Apply for Financial Assistance from

The Breast Form Fund

Who is Eligible?

The Breast Form Fund offers financial assistance to uninsured and under-insured women of all ages and cultural backgrounds who live in Massachusetts and choose to obtain post-mastectomy bras and/or breast prostheses. Breast prostheses are often needed after a simple or modified mastectomy, radical mastectomy, bilateral mastectomy and some lumpectomies. Breast prostheses are usually replaced after two years and bras on an annual basis. This frequency could change depending on insurance coverage or a significant weight change.

How Do I Apply?

When you’re ready to be fitted for your breast form(s) and post-mastectomy bra(s) you will need to obtain a prescription or referral from your doctor. Then visit the location nearest you that offers post-mastectomy services. A Certified Mastectomy Fitter will assist you in filling out the application, and she will submit it to The Breast Form Fund. The Breast Form Fund will process your application within two weeks. The fund gives awards up to $300 per breast prosthesis (every two years) and up to $100 for bra(s) yearly. Reapplication is required to sustain financial support.

Finding a Fitter

When choosing a Certified Mastectomy Fitter, you may want to start by calling a fitter who is located near you. Please check your local Yellow Pages (Prosthetics – Apparel & Accessories) for Certified Fitters in your area or check our MA Mastectomy Fitters List (The list subject to change and is current as of August 2008). Most fitters prefer to set up appointments.

Questions for the Fitter

You may want to spend some time finding a fitter that is right for you. Here are some questions you might want to ask:

• How long have you been a Certified Fitter?
• I would like to apply to The Breast Form Fund. Can you help me?
• Do you have private fitting rooms?
• How long will the appointment take?
• Does it take more than one visit?
• What is the fitting process?
• Can I bring someone with me?
• Do you carry a variety of post-mastectomy products? Prostheses? Bras? Bathing suits?
• What does a breast prosthesis cost?
• Can you put pockets in my existing bras so they can be used with my prosthesis?
• Will I get my prosthesis at the end of my appointment?
• May I return the prosthesis if I’m not happy with it?
• What insurance do you take? Do you take Mass Health?

Although The Breast Form Fund cannot be responsible for your experience with a fitter, we hope that these guidelines are helpful in selecting a Certified Mastectomy Fitter who is friendly, informative and sympathetic to your needs.

What to Bring When You Go

• Insurance card (if you have insurance).
• Prescription or referral from your doctor. (This is a requirement for applying to The Breast Form Fund.)
• The fitter will have The Breast Form Fund application to fill out during the appointment. (We will send information and applications to Certified Mastectomy Fitters who don’t know about The BFF.)

Within two weeks of submitting your application, The Breast Form Fund will contact your fitter about your eligibility to receive assistance. Your fitter may chose to fit you at the first appointment or wait until she has heard back from The BFF. If you are eligible for funding, The BFF will pay the fitter directly for your breast form(s) and mastectomy bra(s).