- Active Health
- Retiree Health
- DB Pension
- DC Pension
- SUB Plan
The Women's Health and Cancer Rights Act (WHCRA) is a federal law that requires group health plans (HMOs and other insurers) providing coverage for mastectomies to also cover reconstructive surgery after a mastectomy in a manner determined in consultation with the attending physician and the patient. Prior to this law, the HMO Plans generally already covered the services now mandated by this law.
Under WHCRA, group health plans and health insurance issuers that provide medical and surgical benefits with respect to a mastectomy must, in the case of a covered individual who is receiving benefits in connection with a mastectomy, also provide coverage for mastectomy-related services including:
This coverage will be provided in consultation with the attending physician and the patient, and will be subject to the same annual deductibles and coinsurance provisions that are consistent with those established for other benefits under the Plan or coverage.
If you have any questions, contact your HMO directly, or contact MedExpert by calling (800) 999-1999.