TAC Health & Employee Benefits Pool

Women's Health and Cancer Rights Act of 1998 Notification

In 1998, the U.S. Congress passed the Women’s Health and Cancer Rights Act of 1998 that provides coverage for reconstructive surgery and related services following a mastectomy in conjunction with a diagnosis of breast cancer.

In the case of a covered person receiving benefits under their plan in connection with a mastectomy and who elects breast reconstruction, coverage will be provided in a manner determined in consultation with the attending physician and the patient for:

• Coverage will be provided for the reconstructive surgery of the breast on which a mastectomy has been performed.
• Coverage will be provided for surgery and reconstruction of the other breast to produce a symmetrical appearance.
• Coverage will be provided for prostheses and physical complications through all stages of a mastectomy, including swelling associated with the removal of lymph nodes.