To: All Eligible WELS VEBA Group Health Care Plan Participants and Dependents
Re: Women’s Health and Cancer Rights Act of 1998
Under this federal law, group health plans that provide medical and surgical benefits to a person who is receiving benefits from the Plan in connection with a mastectomy, must provide benefits for certain reconstructive surgery.
Although the WELS VEBA Group Health Care Plan (the “Plan”) has previously considered this a benefit of the Plan, the law assures that coverage is available for all people who receive Plan benefits in connection with a mastectomy and then elect breast reconstruction.
If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for:
- All stages of reconstruction of the breast on which the mastectomy was performed;
- Surgery and reconstruction of the other breast to produce a symmetrical appearance;
- Prostheses; and
- Treatment of physical complications of the mastectomy, including lymphedema.
Benefits for the above services will be provided subject to the same deductibles, coinsurance and limitations applicable to other covered services under the Plan.
If you have any questions regarding this benefit, please contact the Benefit Plans Office at 1-800-487-8322 or by e-mail to [email protected].