Reconstructive Surgery Notice
On October 21, 1998, President Clinton signed into law a requirement that group health plans sponsored by public and private employers provide coverage for certain reconstructive surgery following a mastectomy. Federal law requires that the benefit detail be disclosed on an annual basis. Therefore, we are distributing this notice. Please contact the Benefits department if you have any questions.
Benefit Requirements
A participant or beneficiary who is entitled to benefits under the PCC health plan in connection with a mastectomy may, in consultation with the attending physician, elect breast reconstruction and the plan will cover:
- Reconstruction of the breast on which the mastectomy has been performed;
- Surgery and reconstruction of the other breast to produce a symmetrical appearance; and
- Prostheses and treatment of physical complications of all stages of mastectomy, including lymph edemas.
The same deductibles, copayments, and coinsurance provisions that apply to other medical, hospital, and surgical benefits will also apply to mastectomy-related services and procedures.