Does Medicare cover Breast reconstructive surgery after bilateral prophylactic Mastectomy for patients with BRCA positive gene mutation and strong family hx (medical history) of breast cancer?
January 22, 2013
Answer: Insurance implications with breast reconstruction
On October 21, 1998, the Women's Health and Cancer Rights Act of 1998, became effective as part of the 1999 Omnibus Consolidated and Emergency Supplemental Appropriation Act. This new federal law requires group health plans and individual health policies that provide coverage for mastectomies to also provide coverage for breast reconstruction in connection with mastectomy.
In accordance with the Women's Health and Cancer Rights Act of 1998, members receiving mastectomy-related services are entitled to the following benefits:
Reconstruction of the breast on which mastectomy has been performed
Surgery and reconstruction of the other breast to produce a symmetrical appearance
Prostheses and treatment of physical complications at all stages of the mastectomy, including lymphedemas
One home health care visit within 48 hours of hospital discharge
Outpatient care following a mastectomy performed in a health care facility
Inpatient skilled nursing facility care in which the length of stay is determined by the treating physician based upon generally accepted criteria for safe discharge
This coverage will be provided in a manner determined in consultation with the attending physician and patient, given that your plastic surgeon accepts your insurance.
Helpful
January 22, 2013
Answer: Insurance implications with breast reconstruction
On October 21, 1998, the Women's Health and Cancer Rights Act of 1998, became effective as part of the 1999 Omnibus Consolidated and Emergency Supplemental Appropriation Act. This new federal law requires group health plans and individual health policies that provide coverage for mastectomies to also provide coverage for breast reconstruction in connection with mastectomy.
In accordance with the Women's Health and Cancer Rights Act of 1998, members receiving mastectomy-related services are entitled to the following benefits:
Reconstruction of the breast on which mastectomy has been performed
Surgery and reconstruction of the other breast to produce a symmetrical appearance
Prostheses and treatment of physical complications at all stages of the mastectomy, including lymphedemas
One home health care visit within 48 hours of hospital discharge
Outpatient care following a mastectomy performed in a health care facility
Inpatient skilled nursing facility care in which the length of stay is determined by the treating physician based upon generally accepted criteria for safe discharge
This coverage will be provided in a manner determined in consultation with the attending physician and patient, given that your plastic surgeon accepts your insurance.
Helpful
July 23, 2012
Answer: Medicare Covers Breast Reconstruction after Mastectomy
It is a federal law that Medicare and all insurance companies cover costs for mastectomy and subsequent reconstruction
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July 23, 2012
Answer: Medicare Covers Breast Reconstruction after Mastectomy
It is a federal law that Medicare and all insurance companies cover costs for mastectomy and subsequent reconstruction
Helpful