Your plan, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy-related services.
Beginning in 1999, Federal law requires your group health plan to provide coverage for the following services to an individual receiving plan benefits in connection with a mastectomy:
- Reconstruction of the breast on which the mastectomy has been performed
- Surgery and reconstruction of the other breast to produce a symmetrical appearance
- Prostheses and physical complications for all stages of a mastectomy, including lymphedemas (swelling associated with the removal of the lymph nodes)
Your group health plan must determine the manner of coverage in consultation with the attending physician and patient.
Coverage for breast reconstruction and related services will be subject to deductibles and coinsurance amounts that are consistent with those that apply to other benefits under the plan.
