Under the Women’s Health and Cancer Rights Act, group health plans and insurers offering mastectomy coverage must also provide coverage for:

  • Reconstruction of the breast on which the mastectomy was performed;
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
  • Prostheses and treatment of physical complications at all stages of the mastectomy, including lymph edemas.

The physician and patient determine the manner in which these services are performed. The law, which went into effect October 21, 1998, does not change the benefits provided under NMU’s health coverage plan which already covered these services.  This notification is merely a formality to comply with federal requirements.  Coverage for breast reconstruction and related services are subject to deductibles and co-pays that are consistent with those that apply to other benefits under the plan.