Women’s Health & Cancer Rights Act of 1998


To: Participants in the UnitedHealthcare Point-of-Service and Out-of-Area Medical Plans
From: Pearson Benefits

In 1998, Congress passed the Women’s Health and Cancer Rights Act. This law requires that medical plans (like our out-of-area and point-of-service plans) provide coverage for reconstructive surgery and related services following a mastectomy.

Here are the details. Coverage will be provided for:

  • Reconstructive surgery of the breast on which a mastectomy has been performed.
  • Surgery and reconstruction of the other breast to produce a symmetrical appearance.
  • Prostheses and physical complications through all stages of a mastectomy, including swelling associated with the removal of lymph nodes.

The actual services provided will be determined by the patient and the attending physician.

Expenses for reconstruction and related services are subject to the same deductibles, co-payments, and/or coinsurance as any other covered medical expense.

If you have any questions or concerns about how this legislation would affect you and your coverage under the medical plan, please call UnitedHealthcare’s Member Services at 1-800-842-7084 for the Point-of-Service Plan and 1-800-638-7287 for the Out-of Area Plan. Otherwise, contact your local Benefits Department.