Women's Health and Cancer Rights Act
The Women’s Health and Cancer Rights Act requires group health plans, under federal law, to make certain benefits available to participants who have undergone a mastectomy. In particular, a plan must offer mastectomy patients benefits for:
- 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
- Treatment of physical complications of mastectomy.
Our plan complies with these requirements. Benefits for these items generally are comparable to those provided under our Plan for similar types of medical services and supplies. Of course, the extent to which any of these items is appropriate following mastectomy is a matter to be determined by consultation between the attending physician and the patient. Our Plan neither imposes penalties (for example, reducing or limiting reimbursements) nor provides incentives to induce attending providers to provide care inconsistent with these requirements.
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