On several occasions throughout my time in reconstructive surgery, I have had women ask me how much the process of breast reconstruction is going to cost them and more specifically, if their insurance covers any aspect of it. And to that I say…
Why yes, yes it does! –thanks to the Women's Health and Cancer Rights Act of 1998 (WHCRA).
This crucial piece of legislation ensures protections for patients undergoing reconstructive breast cancer related surgeries. Enacted on October 21, 1998, WHCRA mandates that health insurance plans offering mastectomy coverage must also provide coverage for reconstructive surgery and other post-mastectomy benefits.
So…what exactly does that mean?
- Reconstructive Surgery Coverage: Health plans must cover reconstruction of the breast on which the mastectomy was performed. This includes all stages of reconstruction and any surgical procedure on the other breast to produce a symmetrical appearance.
- Prostheses: The act ensures coverage for external breast prostheses, which are used to create a breast shape in clothing and other garments to allow for a more comfortable post-surgical appearance.
- Treatment of Complications: WHCRA mandates coverage for any physical complications arising from the mastectomy, including lymphedema.
By ensuring comprehensive post-surgical coverage, including reconstructive surgery and necessary follow-up treatments, the act supports women in their recovery journey. It also promotes equality in healthcare by making reconstructive options accessible, helping women regain their confidence and normalcy post-surgery.