Insurance Coverage for Breast Reconstruction
If you had a recent mastectomy, or are preparing for a mastectomy, you may be looking at breast reconstruction options and wondering if breast reconstruction is covered by insurance. Due to Federal and state laws that mandate insurance coverage for breast reconstruction following a mastectomy, most insurance companies provide insurance coverage for breast reconstruction, although there may be some restrictions on coverage.
Insurance Coverage for Breast Reconstruction (Federal Laws)
The Women's Health and Cancer Rights Act (WHCRA) of 1998 mandates that, under certain circumstances, insurance coverage be provided to women with breast cancer who choose to undergo breast reconstruction following a mastectomy. WHCRA also mandates that group health plans and private insurers provide the following breast reconstruction insurance coverage:
- Breast reconstruction of the affected breast
- Breast reconstruction of the unaffected breast, if necessary, to make both breasts look the same
- The cost of breast implants
Companies that provide insurance benefits for breast reconstruction may require you to pay an annual deductible and a surgical co-pay.
Insurance Coverage for Breast Reconstruction (State Laws)
Many states also require that insurers provide coverage for breast reconstruction, although not all insurance plans are subject to state law. To view information about your state’s laws, click here.
Before scheduling your breast reconstruction surgery, check with your insurance company to find out what is covered.
Refrences
- American Cancer Society. Women’s Health and Cancer Rights Act