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Women’s Health and Cancer Rights Act of 1998 Annual Notice
Dear Member:
“Did you know that your medical plan, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy-related services including reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy (including lymphedema)? Under federal law, group health plans, insurers and HMOs that provide medical and surgical benefits in connection with a mastectomy must provide benefits for certain reconstructive surgery, effective for the first plan year beginning on or after October 21, 1998. In the case of a participant or beneficiary who is receiving benefits under the plan in connection with a mastectomy and elects breast reconstruction, federal law requires coverage in a manner determined in consultation with the attending physician and patient, for:
· Reconstruction of the breast on which the mastectomy was performed · Surgery and reconstruction of the other breast to produce a symmetrical appearance: and · Prostheses and treatment of physical complication at all stages of the mastectomy, including lymphedemas
This coverage is subject to a plan’s annual deductibles and coinsurance provision. These provisions are generally described in the plan’s Summary Plan Description (SPD). If you have any questions about whether your plan covers mastectomies or reconstructive surgery, please contact your Plan Administrator at (212)925-0005.
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Day Care Council-Local 205, D.C. 1707 Welfare Fund / Group Legal Fund
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