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Breast Augmentation Breast Reconstruction

Breast Reconstruction: Know Your Rights

166421094Breast reconstruction at my San Diego practice is very common following a mastectomy. However, not all women are aware that they have legal rights when it comes to breast reconstruction.

The Women’s Health and Cancer Rights Act of 1998 (WHCRA) is a federal mandate requiring insurance companies offering coverage for mastectomies to also offer coverage for reconstruction. This applies to private insurance, group health plans and even HMOs. Full reconstruction is not the only service that’s covered, either. Surgery that’s needed in order to restore symmetry to the breasts, consultations, prostheses, and treatments related to complications of the original mastectomy are also required to be covered.

It’s good to bear in mind that the WHCRA does not mean that mastectomies are necessarily covered by your insurance company. Rather, the insurance companies that do provide coverage for mastectomies must also include coverage for the resultant breast reconstruction. At my San Diego practice, patients who visit me with concerns about restoring the size and shape of their breasts after a mastectomy are often unaware of their rights to reconstruction.

If you have health concerns that would necessitate a mastectomy, check your policy to see if the procedure is covered. If so, you should know that reconstruction coverage by your insurance company is mandated by federal law, and will not be considered a cosmetic procedure. Know your rights, and get the healthcare coverage that you deserve.

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September 15, 2012
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September 15, 2012