Steps to receive Medicare Reimbursement:

To receive Medicare Reimbursement, please print, complete and mail the following documents to your Medical Regional Office for your state:

1. Complete and sign #1490S Medicare reimbursement billing form.

2. The original receipt showing the item purchased and total price.

3. A copy of the Certificate of Medical Necessity complete and signed by your physician.

4. A prescription from your physician.

5. Contact Medicare at 1-800-633-4227 to find the current mailing address for the regional office for your state.  Submit the original paperwork to Medicare and always keep a copy of each item for your records.

Medicare Reimbursement:

Medicare reimburses 80% of the allowable for one Gentle Touch Medical Products, Inc. Camisole immediately post surgery, and also additional Camisole if the Gentle Touch Medical Products, Inc. is worn as a permanent prosthesis.  Reimbursement dollar amounts vary from state to state.  After Medicare pays, secondary insurance carriers are usually required to cover a portion of any remaining cost.

How to use Form 1490S for Reimbursement:

The Medicare description for the Gentle Touch Medical Care, Inc. camisole is, "External breast prosthesis garment, with mastectomy form - post mastectomy".

How to obtain a 1490S Medicare Form:

  • Download a blank form 1490S and form instructions.
  • Go to the Medicare website to download 1490S billing form.
  • Call 1-800-633-4227 to find the Medicare regional office for your state to order the form by mail.
  • Upon request, a sample of this form will be included with your Gentle Touch camisole shipment.

How to obtain a prescription:

For more information or questions please contact our Customer Service Department, Monday through Friday 9:00 a.m. - 5:00 p.m. Eastern time at 1-(800)-989-5726.