The Women's Health and Cancer Rights Act (WHCRA) of 1998 is a federal law that helps protect health plan members who choose to have breast reconstruction after a mastectomy.
If you are receiving benefits in connection with a mastectomy, and you decide to have breast reconstruction, coverage must be provided, in a manner determined in consultation with the attending physician and the patient, for:
All stages of reconstruction of the breast on which the mastectomy has been performed;
Surgery and reconstruction of the other breast for a balanced appearance;
Prostheses, such as bra inserts, that are needed before or during reconstruction surgery; and
Treatment of physical complications during all stages of the mastectomy. This includes lymphedema, swelling caused by a buildup of fluid in the arm and hand or other areas near the surgery site.
These benefits will be provided subject to eligibility and plan benefits including deductibles, coinsurance, and out of pocket.
All other features and benefits of your policy remain the same and are not impacted by this annual notification.
If you have any questions regarding this notification, please contact the Customer Service number found on your ID card.