Women\'s Health & Cancer Rights Act of 1998

Women's Health & Cancer Rights Act of 1998

On October 21, 1998, the Women's Health and Cancer Rights Act of 1998, became effective as part of the 1999 Omnibus Consolidated and Emergency Supplemental Appropriation Act. This new federal law requires group health plans and individual health policies that provide coverage for mastectomies to also provide coverage for breast reconstruction in connection with such mastectomy.

  • In accordance with the Women’s Health and Cancer Rights Act of 1998, members receiving mastectomy-related services are entitled to the following benefits:

  • 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 at all stages of the mastectomy, including lymphedemas;

  • one home health care visit within 48 hours of hospital discharge;

  • outpatient care following a mastectomy performed in a health care facility; and

  • inpatient and skilled nursing facility care in which the length of stay is determined by the treating physician based upon generally accepted criteria for safe discharge.

This coverage will be provided in a manner determined in consultation with the attending physician and the patient. These benefits are subject to any deductible or coinsurance requirements that may apply to your coverage.