If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. Breast Cancer Research and Treatment 2012; 133(3):1125-1130. Under the WHCRA, group health plans, insurance companies, and HMOs that offer mastectomy coverage must also provide coverage for reconstructive surgery after mastectomy. Subcutaneous mastectomy as an alternative treatment for non-cancerous breast diseases for patients who are not at high risk for breast cancer.Mar 20, 2022. What Health Insurance Cover Prophylactic Mastectomy The prophylactic mastectomy is classified as a preventive surgery and is "generally not covered whether at the local or national level," the CMS spokesperson explained. Prophylactic Surgeries For Breast Cancer - SurgeryTalk.net Help us end cancer as we know it,for everyone. If an employer is self-insured, state laws do not apply but federal laws do. Medicare Benefits for a Mastectomy. Can a woman have risk-reducing surgery if she has already been diagnosed with breast cancer? Website:www.naic.org Do insurance companies cover mastectomy? The annual notice may be sent by itself or it may be included in almost any written communication by the plan or insurer, such as newsletters, annual reports, policy renewal letters, enrollment notices, and others. The chest wall, which is not typically removed during a mastectomy, may contain some breast tissue, and breast tissue can sometimes be found in the armpit, above the collarbone, and as far down as the abdomenand it is impossible for a surgeon to remove all of this tissue. Insurance companies usually pay for the surgery if your doctor says it's needed,. April . Accessed athttps://www.dol.gov/general/topic/health-plans/womens on May 13, 2019. In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., Surgery to Reduce the Risk of Breast Cancer was originally published by the National Cancer Institute.. TRICARE covers services that are medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition . A woman who is considering prophylactic mastectomy may also want to talk with a surgeon who specializes in breast reconstruction. To check on coverage for specific items, visit Medicares website. Preventive Surgery to Reduce Breast Cancer Risk
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