Your Highmark Blue Shield programs provide coverage for mastectomies. In addition to this coverage, and in compliance with federal Women's Health and Cancer Rights Act, mastectomy patients who elect to have reconstructive surgery also have these benefits, effective January 1, 1999:
1. Reconstructive surgery for the breast on which the mastectomy was performed;
2. Reconstructive surgery for the other breast to provide a symmetrical appearance;
3. Prostheses; and
4. Treatment of physical complications at all stages of mastectomy, including lymphedemas.
Depending on your specific coverage, some of these benefits may have time restrictions, and you may have other benefits available to you relating to mastectomy services.
These services are subject to the same deductibles, co-pays, and/or coinsurance that are applicable to your program.
The extent to which any of these items is appropriate following a mastectomy is a matter to be determined in consultation with the physician and the patient.