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In 1998, Congress passed HR 4328, also known as the Women's Health and Cancer Rights Act of 1998. This legislation requires group health plans and health insurance issuers of group health insurance to cover reconstructive surgery following a mastectomy/lumpectomy and to notify you of this coverage annually.

Specifically, if health plans and insurers cover mastectomies/lumpectomies, they must also cover, in a manner determined in consultation with the attending physician and the patient:

  1. Reconstruction of the breast on which the mastectomy/lumpectomy was performed;
  2. Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
  3. Prostheses and treatment of physical complications at all stages of the mastectomy/lumpectomy, including lymphedemas.

Benefits are subject to the standard surgical deductibles, copayments and coinsurance amounts of your contract/policy. If you have any questions, please contact our Customer Services Department at 1-800-627-1188.

Womens Health and Cancer Rights Act (WHCRA) - PDF