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Does health insurance cover breast reconstruction surgery?

The Women’s Health and Cancer Rights Act (WHCRA) of 1998 is a federal law that that requires health insurance companies and self-insured group health plans that cover mastectomies to also provide benefits for mastectomy-related services, including breast reconstruction surgery.

Does insurance cover a mastectomy?

Mastectomy is surgery to remove all or part of the breast. This federal law requires most group insurance plans that cover mastectomies to also cover breast reconstruction. It was signed into law on October 21, 1998.

Does insurance cover reconstructive surgery after cancer treatment?

Cancer treatments sometimes damage a body part’s function or appearance. Reconstructive surgery helps repair that damage. Reconstructive surgery differs from cosmetic surgery because reconstructive surgery is done for a medical reason. Most insurance companies cover reconstructive surgery that is needed after cancer treatment.

Do I need additional cancer treatment after breast reconstruction surgery?

Whether you need additional cancer treatment after surgery is a particularly important factor because some treatments, like radiation therapy, can affect your reconstruction. In this case, you may have more than 1 surgery. An option may be to start with a "temporizing procedure." This is a temporary repair that is done before radiation therapy.

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