If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1988 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will 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 was performed;
- Surgery and reconstruction of the other breast to produce a symmetrical appearance;
- Prostheses, and
- Treatment of physical complications of the mastectomy, including lymphedema.
These benefits will be provided subject to the same copayments, deductibles, and After meeting the annual deductible, participants and the medical plan share coinsurance costs of some services, calculated by percent paid by both until reaching the annual out-of-pocket maximum. For out-of-network, participants pay above reasonable and customary limits. provisions applicable to other medical and surgical benefits provided under the plan. Please refer to your Summary Plan Description (SPD) for copayment, deductible, and coinsurance information applicable to the plan in which you choose to enroll.
If you would like more information on WHCRA benefits, contact the Benefits Team.