Women's Health and Cancer Rights Act of 1998

The Women's Health and Cancer Rights Act was signed into law on October 21, 1998. This law provides mandatory coverage for women with respect to medical and surgical benefits after having a mastectomy, providing that the health plan covers mastectomies. Group health plans, as well as health insurance issuers that offer coverage for mastectomies, are required to provide the coverage to participants of group health plans, as well as to those participants enrolled in an individual plan. Benefits under the Act include:

  1. All stages of reconstruction of the breast on which the mastectomy has been performed
  2. Surgery and reconstruction of the other breast to produce a symmetrical appearance
  3. Prosthesis
  4. Medical complications at all stages of the mastectomy, including lymphedemas

Copays, coinsurance and deductibles apply as long as they are consistent with other benefits under the plan. Additionally, persons moving from one plan to another may be required to comply with the new plan's pre-existing condition limitations, subject to HIPAA (Health Insurance Portability and Accountability Act) restrictions.