On October 21, 1998, the Women's Health and Cancer Rights Act of
1998, became effective as part of the 1999 Omnibus Consolidated
and Emergency Supplemental Appropriation Act. This new federal law
requires group health plans and individual health policies that
provide coverage for mastectomies to also provide coverage for breast
reconstruction in connection with such mastectomy.
In accordance with the Womens Health and Cancer Rights Act
of 1998, members receiving mastectomy-related services are entitled
to the following benefits:
- reconstruction of the breast on which the mastectomy has been
- surgery and reconstruction of the other breast to produce a
- prostheses and treatment of physical complications at all stages
of the mastectomy, including lymphedemas;
- one home health care visit within 48 hours of hospital discharge;
- outpatient care following a mastectomy performed in a health
care facility; and
- inpatient and skilled nursing facility care in which the length
of stay is determined by the treating physician based upon generally
accepted criteria for safe discharge.
This coverage will be provided in a manner determined in consultation
with the attending physician and the patient. These benefits are
subject to any deductible or coinsurance requirements that may apply
to your coverage.