Member Services Menu
Search
Notice:
On October 21, 1998, a federal law, the Women’s Health and Cancer Rights Act, became effective. The Federal law is similar to a law that was previously passed and then revised by the North Carolina General Assembly (Coverage for Breast Reconstructive Surgery Resulting from Mastectomy). The Federal and State laws require group health plans that provide coverage for mastectomies to also cover the reconstructive surgery and prosthesis following mastectomies. We are please to inform you that your health plan is in compliance with this law.
The laws mandate that a member who receives benefits for a medically necessary mastectomy and then elects breast reconstruction after the mastectomy, will also receive coverage for:
- Reconstruction of the breast on which the mastectomy was performed
- Surgery and reconstruction of the other breast to produce a symmetrical appearance
- Prostheses
- Treatment of physical complication of all stages of mastectomy, including lymphedemas
This coverage is provided in consultation with the attending physician and the patient, and is subject to the benefit coverage provisions that apply for the mastectomy.
If you have questions about coverage of mastectomies and reconstructive surgery, please contact Member services at 910-715-8100 or 800-574-8556.