Your Health Plan Covers Reconstructive Surgery After a Mastectomy

It’s normal to be anxious if you find out you need to have a mastectomy due to breast cancer. A mastectomy is the removal of one or both breasts. This procedure is most often performed to treat breast cancer.

If you are facing this surgery, take some comfort in knowing that federal and state laws require health insurance companies to cover reconstructive surgery afterward.

If you and your doctor decide they’re necessary, these treatments can be covered after a mastectomy due to breast cancer:

• Rebuilding the breast that was removed
• Surgery on the other breast for an even appearance
• Breast implants
• Flap procedures (to replace lost skin and tissue)
• Mastopexy (breast lift)
• Nipple reconstruction and tattooing 

Your health plan covers inpatient hospital services for 48 hours of inpatient care following a mastectomy due to breast cancer.

The same deductible and coinsurance as other medical and surgical benefits covered by your plan apply.

It’s important to understand your options. For more information, call the customer service number on your member ID card. Ask to be transferred to the case management department to discuss your coverage with a registered nurse.

Originally published 9/4/2020; Revised 2022, 2023, 2024