Administrative Information

Women's Health and Cancer Rights

If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for:       

  • all stages of reconstruction of the breast on which the mastectomy was performed;

  • surgery and reconstruction of the other breast, to produce a symmetrical appearance;
  • prosthesis; and
  • treatment of physical complications of all stages of mastectomy, including lymphedema. 

Prior authorization is NOT required for these services, unlike other reconstructive services.

These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under the medical plan(s).