Women’s Health and Cancer Rights Act of 1998
Under federal legislation, annual notification of this benefit is required to all members.
In 1998, the federal government enacted a law that mandates certain health coverage for breast reconstructive surgery in any health program that provides medical and surgical benefits for mastectomies. This law is known as the Women’s Health and Cancer Rights Act.
If a covered person is receiving benefits in connection with a mastectomy and elects to have breast reconstruction along with that mastectomy, the policy must provide in a manner determined in consultation with the attending physician and the patient, coverage for the following:
- All stages of reconstruction of the breast on which the mastectomy was performed;
- Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
- Prostheses and physical complications at all stages of the mastectomy, including lymphedemas.
These benefits will be provided subject to deductibles and coinsurance to the same extent as for any other illness under your coverage.
All other features and benefits of this program remain the same and are not impacted by this annual notification.