Your Health Plan Covers Reconstructive Surgery After a Mastectomy

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. 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 will be covered after a mastectomy:

  • Rebuilding the breast that was removed
  • Surgery on the other breast for an even appearance
  • Breast implants
  • Treatment of possible side effects from the mastectomy, including lymphedema (fluid buildup that leads to swelling)

Your health plan covers inpatient hospital services for at least 48 hours of inpatient care following a mastectomy. And your health plan covers at least 24 hours of inpatient care following a lymph node dissection for treatment of breast cancer.

Coverage may be provided for a shorter in-patient hospital stay when you and your doctor decide that a shorter hospital stay is appropriate.

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

For more information, call the customer service number on your member ID card.

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