The U.S. Women's Health and Cancer Rights Act (WHCRA), signed into law on October 21, 1998, contains protections for patients who elect breast reconstruction in connection with a mastectomy. For plan participants and beneficiaries receiving benefits in connection with a mastectomy, plans offering coverage for a mastectomy must also cover reconstructive surgery and other benefits related to a mastectomy.
Generally, group health plans, as well as their insurance companies and Health Maintenance Organization's (HMOs), that provide coverage for medical and surgical benefits with respect to a mastectomy must comply with WHCRA. However, if your coverage is provided by a "church plan" or "governmental plan" it may not be subject to this law.
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