{"id":355853,"date":"2016-04-04T10:46:17","date_gmt":"2016-04-04T15:46:17","guid":{"rendered":"https:\/\/ability-fl-prod.internetbrands.com\/ability-law\/healthcare\/patient-rights\/womens-health-and-cancer-rights-act-overview.html"},"modified":"2026-08-18T09:23:00","modified_gmt":"2026-08-18T14:23:00","slug":"womens-health-and-cancer-rights-act-overview","status":"publish","type":"page","link":"https:\/\/www.findlaw.com\/healthcare\/patient-rights\/womens-health-and-cancer-rights-act-overview.html","title":{"rendered":"What Is the Women&#8217;s Health and Cancer Rights Act?"},"content":{"rendered":"\n<div class=\"wp-container-core-columns-is-layout-9d6595d7 fl-sectionWithSidebar fl-container fl-flex fl-flex-wrap fl-gap30\">\n<div class=\"fl-page-articles fl-section-main fl-section-main-full-width\"><h1 class=\"fl-no-margin-top\">What Is the Women&#039;s Health and Cancer Rights Act?<\/h1>\n\n<section class=\"fl-gutenberg-byline\">\n    <div class=\"fl-gutenberg-byline-content\">\n                    By <a href=\"https:\/\/www.findlaw.com\/company\/our-team\/melissa-mccall-j-d\/\">Melissa McCall, J.D.<\/a> | Legally reviewed by <a\n                href=\"https:\/\/www.findlaw.com\/company\/our-team\/aviana-cooper-esq\/\">Aviana Cooper, Esq.<\/a>\n                | Last updated\n        <time>\n                            August 18, 2026\n                    <\/time>\n    <\/div>\n\n    \n    <details class=\"fl-gutenberg-byline-toggle fl-gutenberg-byline-legally-reviewed\">\n        <summary>\n            <i class=\"fl-gutenberg-byline-icon\" aria-hidden=\"true\"><\/i>\n            Legally Reviewed\n        <\/summary>\n\n        <div class=\"fl-gutenberg-byline-toggle-content\">\n            <p><em>This article has been written and reviewed for legal accuracy, clarity, and style by <a href=\"https:\/\/www.findlaw.com\/company\/our-team.html\">FindLaw\u2019s team of legal writers and attorneys<\/a> and in accordance with <a href=\"https:\/\/www.findlaw.com\/company\/company-history\/editorial-policy.html\">our editorial standards<\/a>.<\/em><\/p>\n\n        <\/div>\n    <\/details>\n\n    <details class=\"fl-gutenberg-byline-toggle fl-gutenberg-byline-fast-checked\">\n        <summary>\n            <i class=\"fl-gutenberg-byline-icon\" aria-hidden=\"true\"><\/i>\n            Fact-Checked\n        <\/summary>\n\n        <div class=\"fl-gutenberg-byline-toggle-content\">\n            <p><em>The last updated date refers to the last time this article was reviewed by FindLaw or one of our <a href=\"https:\/\/www.findlaw.com\/company\/our-team\/contributing-authors.html\">contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please <a href=\"https:\/\/lawyers.findlaw.com\/?fli=bylinelink\" target=\"_blank\" rel=\"noopener\">contact an attorney in your area<\/a>.<\/em><\/p>\n\n        <\/div>\n    <\/details>\n<\/section>\n\n\n<div class=\"fl-key-takeaways fl-mb30\" data-testid=\"fl-key-takeaways\">\n    <div class=\"fl-card-content\">\n        <div class=\"fl-card-body fl-card-bg-teal fl-flex fl-flex-column\">\n                            <h2 class=\"fl-card-title fl-h2 fl-no-margin\">Key Takeaways<\/h2>\n                        <div data-testid=\"ai-message-body\">\n<div>\n<div id=\"16iNtegDofjr9tuRLfYhJ-content-0\">\n<p>The Women\u2019s Health and Cancer Rights Act requires group health plans that cover mastectomies to also cover breast reconstruction and related post\u2011surgery care. It ensures patients receive reconstruction, prostheses, and treatment for complications like lymphedema whenever mastectomy coverage is offered.<\/p>\n<\/div>\n<\/div>\n<\/div>\n\n        <\/div>\n    <\/div>\n<\/div>\n\n\n<p>The\u00a0Women&#8217;s Health and Cancer Rights Act\u00a0(1998), or WHCRA, is a federal law that provides certain protections to breast cancer patients who want breast reconstruction surgery. Under the\u00a0<a href=\"https:\/\/www.dol.gov\/sites\/dolgov\/files\/EBSA\/about-ebsa\/our-activities\/resource-center\/faqs\/whcra.pdf\" target=\"_blank\" rel=\"noopener\">WHCRA<\/a>, all group health plans that cover mastectomies must provide coverage for reconstructive surgery and any other post-mastectomy benefits.<\/p>\n<p>The WHCRA does not require health insurers or group health plans to cover mastectomies, but if they do, they are subject to the WHCRA. The WHCRA covers mastectomy for any medical reason, not just to treat breast cancer.<\/p>\n<p>The\u00a0<a href=\"https:\/\/www.cms.gov\/CCIIO\/Programs-and-Initiatives\/Other-Insurance-Protections\/whcra_factsheet\" target=\"_blank\" rel=\"noopener\">Women&#8217;s Health and Cancer Rights Act<\/a>\u00a0amends the\u00a0<a href=\"https:\/\/www.findlaw.com\/employment\/wages-and-benefits\/faq-pension-plans-and-erisa.html\" target=\"_self\">Employee Retirement Income Security Act (ERISA)<\/a>\u00a0of 1974. ERISA identifies administrative standards for employers who offer group plans. This includes health insurance or retirement plans.<\/p>\n<p>This article explores the Women&#8217;s Health and Cancer Rights Act. If your plan isn\u2019t providing these benefits, a local <a href=\"https:\/\/lawyers.findlaw.com\/health-health-care-law\/\" target=\"_blank\" rel=\"noopener\">healthcare attorney<\/a> can help you understand and enforce your rights under WHCRA.<\/p>\n<h2>The Women&#8217;s Health and Cancer Rights Act<\/h2>\n<p>Congress passed the WHCRA after a health insurance company refused to cover reconstructive surgery for a\u00a0breast cancer patient.\u00a0This law covers health insurance companies, HMOs, and private group health plans. It does not cover state and local government health plans. According to the Centers for Medicare and Medicaid Services, group plans can be &#8221; insured &#8221; or &#8220;self-funded&#8221; plans.<\/p>\n<h3>Health Insurance Basics<\/h3>\n<p>Health insurance is a contract between you and a health insurer. In exchange for paying a premium, they cover your healthcare costs. The details of your health coverage-coinsurance, deductibles, and co-pays\u2014depend on your contract or policy. Your policy also outlines the health benefits offered by your insurer. Health benefits include the <a href=\"https:\/\/www.healthcare.gov\/glossary\/benefits\/#:~:text=The%20health%20care%20items%20or%20services%20covered%20under%20a%20health%20insurance%20plan.\" target=\"_blank\" rel=\"noopener\">healthcare items or services provided under a health insurance plan<\/a>.<\/p>\n<h3>Mastectomies and Breast Reconstruction<\/h3>\n<p>A mastectomy is a\u00a0<a href=\"http:\/\/www.breastcancer.org\/treatment\/surgery\/mastectomy\" target=\"_blank\" rel=\"noopener\">surgical procedure that removes breast tissue<\/a>\u00a0to treat or prevent breast cancer. With some mastectomies &#8212; called &#8220;simple&#8221; or &#8220;total&#8221; mastectomies &#8212; a surgeon removes all the breast tissue.<\/p>\n<p>Breast reconstruction is a\u00a0<a href=\"http:\/\/www.cancer.org\/cancer\/breastcancer\/moreinformation\/breastreconstructionaftermastectomy\/breast-reconstruction-after-mastectomy-br-recon-choices\" target=\"_blank\" rel=\"noopener\">surgery that rebuilds the breast<\/a>\u00a0to give an appearance like the breast pre-mastectomy. Reconstructive surgery can take place concurrently or at some point after surgery.<\/p>\n<p>Women choose breast reconstruction for many reasons, including the following:<\/p>\n<ul>\n<li>To give their upper bodies a more balanced appearance<\/li>\n<li>To regain the breast shape lost after a mastectomy<\/li>\n<li>To get rid of the need for a prosthesis or synthetic breast part that fits inside a bra<\/li>\n<li>To maintain body image and self-esteem<\/li>\n<\/ul>\n<h2>ERISA and the WHCRA<\/h2>\n<p>ERISA covers\u00a0<a href=\"https:\/\/www.findlaw.com\/employment\/wages-and-benefits\/erisa-and-healthcare-plan-enforcement.html\" target=\"_self\">health insurance plans<\/a>\u00a0provided by private employers. ERISA does not cover plans offered to employees of state and local governments. Since the Women&#8217;s Health and Cancer Rights Act is an amendment to ERISA, this law covers those employed by private, non-governmental employers.<\/p>\n<p>The Employee Benefits Security Administration (EBSA) oversees private health plans. The EBSA is a U.S. Department of Labor (USDOL) office. EBSA administers and enforces the &#8220;<a href=\"https:\/\/www.dol.gov\/agencies\/ebsa\/about-ebsa\/about-us\/history-of-ebsa-and-erisa#:~:text=The%20Employee%20Benefits%20Security%20Administration,Act%20of%201974%20(ERISA).\" target=\"_blank\" rel=\"noopener\">fiduciary, reporting, and disclosure provisions<\/a>&#8221; of ERISA. The\u00a0<a href=\"http:\/\/www.cms.gov\/\" target=\"_blank\" rel=\"noopener\">Centers for Medicare and Medicaid Services<\/a>\u00a0regulate state and local government plans for the WHCRA. State laws regulate individually purchased plans.<\/p>\n<hr \/>\n<div data-testid=\"ai-message-body\">\n<div>\n<div id=\"PG5e6BaesPXUqpAPQSSGs-content-0\">\n<p>For disputes involving ERISA plans, appeals, or wrongful denials, an attorney can protect your benefits and help secure what you&#8217;re entitled to. <a href=\"https:\/\/lawyers.findlaw.com\/health-health-care-law\/\" target=\"_blank\" rel=\"noopener\">Find local legal help<\/a>.<\/p>\n<hr \/><\/div>\n<\/div>\n<\/div>\n<div>\u00a0<\/div>\n<h2>Your Rights Under The WHCRA<\/h2>\n<p>The Women&#8217;s Health and Cancer Rights Act doesn&#8217;t make health insurance plans cover mastectomies. The WHCRA&#8217;s mandate is simple: if a <a href=\"https:\/\/www.findlaw.com\/consumer\/insurance\/health-insurance.html\">health insurance plan<\/a> offers mastectomy coverage, that plan must also cover surgical benefits. These surgical benefits include breast reconstruction.<\/p>\n<p>Coverage includes all stages of the mastectomy and\u00a0<a href=\"https:\/\/www.webmd.com\/breast-cancer\/breast-reconstruction-after-mastectomy\" target=\"_blank\" rel=\"noopener\">breast reconstruction surgery<\/a>. Some of the rights covered by eligible plans under WHCRA include the following:<\/p>\n<ul>\n<li>Being informed by health insurance issuers about WHCRA benefits. Issuers must do this at enrollment and annual renewal<\/li>\n<li>Coverage for the reconstruction of a breast or breasts removed in a mastectomy<\/li>\n<li>Coverage for surgery and reconstruction of the other breast for a symmetrical appearance<\/li>\n<li>Coverage for all stages of reconstruction of the breast<\/li>\n<li>Coverage for breast prostheses (artificial breasts that fit into a bra) for use before or during breast reconstruction<\/li>\n<li>Complete coverage for post-surgical treatment of physical complications, such as lymphedema<\/li>\n<\/ul>\n<p>Under the\u00a0WHRCA, health insurance providers\u00a0cannot deny coverage or continuation of coverage to avoid meeting its requirements. Health insurance companies cannot provide incentives to physicians to avoid these requirements either.<\/p>\n<h2>The WHCRA and the Affordable Care Act<\/h2>\n<p>While the <a href=\"https:\/\/www.findlaw.com\/healthcare\/patient-rights\/obamacare-basics-understanding-the-affordable-care-act.html\">Affordable Care Act<\/a> (ACA) of 1998 did not change any provisions of the\u00a0WHCRA, it did offer some new protections. Under the ACA, health insurers cannot deny insurance coverage based on a pre-existing condition. This includes breast cancer. The only exceptions are as follows:<\/p>\n<ul>\n<li>The health plan is a group health plan that started before October 1, 1998, or<\/li>\n<li>The plan does not offer mastectomy coverage.<\/li>\n<\/ul>\n<h2>How To Find Legal Help<\/h2>\n<p>Healthcare law is a complicated legal area. It encompasses medicine and the law, two highly regulated areas that can be overwhelming and confusing for patients and their families. The Women&#8217;s Health and Cancer Rights Act is no exception. Speak to a local experienced <a href=\"https:\/\/www.findlaw.com\/hirealawyer\/choosing-the-right-lawyer\/health-and-health-care-law.html\" target=\"_self\">health care law lawyer<\/a> to learn more.<\/p>\n<p class=\"\">FindLaw\u2019s\u00a0directory of\u00a0<a href=\"https:\/\/lawyers.findlaw.com\/health-health-care-law\/\" target=\"_blank\" rel=\"noopener\">healthcare attorneys<\/a> can get you started. Enter your city or ZIP code for a list of qualified legal professionals near you. Because your state\u2019s laws are relevant, your attorney should be licensed in your state. Your search results will also show important details about prospective attorneys, like ratings and whether they offer free case evaluations.\u00a0<\/p>\n\n\n<div class=\"was-this-helpful\">\n    <div\n            class=\"was-this-helpful__question-container\"\n            aria-labelledby=\"was-this-helpful__question\"\n            role=\"group\"\n    >\n        <span\n                id=\"was-this-helpful__question\"\n                class=\"was-this-helpful__question fl-text-lg-bold\"\n        >Was this helpful?<\/span>\n        <button\n                class=\"was-this-helpful__button fl-text-sm\"\n                aria-label=\"Yes\"\n                value=\"yes\"\n        >\n            <span class=\"was-this-helpful__button-text fl-text-bold\">Yes<\/span>\n            <i class=\"was-this-helpful__button-icon\">\n                <svg width=\"22\" height=\"22\" viewBox=\"0 0 22 22\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <g id=\"thumbs-up\" 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class=\"was-this-helpful__choose-option-message\" role=\"status\">\n            <p class=\"was-this-helpful__choose-option-message-text\"><\/p>\n        <\/div>\n        <form class=\"was-this-helpful__feedback-form\">\n            <div class=\"was-this-helpful__feedback was-this-helpful__feedback--positive\">\n                <fieldset>\n                    <legend class=\"was-this-helpful__feedback-form-title\" tabindex=\"0\">Why was this helpful?<\/legend>\n                    <div class=\"fl-radio-button-field fl-flex was-this-helpful__feedback-form-title\">\n                        <input\n                                id=\"was-this-helpful__radio-button--understandable\"\n                                class=\"fl-radio-button-field-input\"\n                                type=\"radio\"\n                                name=\"positive-feedback\"\n                                value=\"Easy to understand\"\n                        >\n                        <label\n            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<fieldset>\n                    <legend class=\"was-this-helpful__feedback-form-title\" tabindex=\"0\">Why was this not helpful?<\/legend>\n                    <div class=\"was-this-helpful__choose-option-message\" role=\"status\">\n                        <p class=\"was-this-helpful__choose-option-message-text\"><\/p>\n                    <\/div>\n                    <div class=\"fl-radio-button-field fl-flex was-this-helpful__feedback-form-title\">\n                        <input\n                                id=\"was-this-helpful__radio-button--missing-info\"\n                                class=\"fl-radio-button-field-input\"\n                                type=\"radio\"\n                                name=\"negative-feedback\"\n                                value=\"Missing Information\"\n                        >\n                        <label\n                                class=\"fl-radio-button-field-label fl-text-sm was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--missing-info\"\n                        >Missing the information I need<\/label>\n                    <\/div>\n                    <div class=\"fl-radio-button-field fl-flex was-this-helpful__feedback-form-title\">\n                        <input\n                                id=\"was-this-helpful__radio-button--complicated\"\n                                class=\"fl-radio-button-field-input\"\n                                type=\"radio\"\n                                name=\"negative-feedback\"\n                                value=\"Too complicated\"\n                        >\n                        <label\n                                class=\"fl-radio-button-field-label fl-text-sm was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--complicated\"\n                        >Too complicated \/ too many steps<\/label>\n                    <\/div>\n                    <div class=\"fl-radio-button-field fl-flex was-this-helpful__feedback-form-title\">\n                        <input\n                                id=\"was-this-helpful__radio-button--dated\"\n                                class=\"fl-radio-button-field-input\"\n                                type=\"radio\"\n                                name=\"negative-feedback\"\n                                value=\"Out of date\"\n                        >\n                        <label\n                                class=\"fl-radio-button-field-label fl-text-sm was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--dated\"\n                        >Out of date<\/label>\n                    <\/div>\n                    <div class=\"fl-radio-button-field fl-flex was-this-helpful__feedback-form-title\">\n                        <input\n                                id=\"was-this-helpful__radio-button--negative-other\"\n                                class=\"fl-radio-button-field-input\"\n                                type=\"radio\"\n                                name=\"negative-feedback\"\n                                value=\"Other\"\n                        >\n                        <label\n                                class=\"fl-radio-button-field-label fl-text-sm was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--negative-other\"\n                        >Other<\/label>\n                    <\/div>\n                <\/fieldset>\n            <\/div>\n            <div class=\"was-this-helpful__form-buttons-container\">\n                <button\n                    class=\"was-this-helpful__feedback-button was-this-helpful__feedback-button--positive at-feedback-submit fl-button secondary\"\n                    type=\"submit\"\n                >\n                    <span class=\"fl-button-content\">Submit<\/span>\n                    <i\n                        class=\"fa fa-angle-right medium\"\n                        aria-hidden=\"true\"\n                    ><\/i>\n                <\/button>\n                <button\n                    class=\"was-this-helpful__feedback-button was-this-helpful__feedback-button--cancel fl-button primary disabled\"\n                    type=\"reset\"\n                >\n                    <span class=\"fl-button-content\">Cancel<\/span>\n                    <i\n                        class=\"fa fa-times-circle medium\"\n                        aria-hidden=\"true\"\n                    ><\/i>\n                <\/button>\n            <\/div>\n        <\/form>\n    <\/div>\n    <div class=\"was-this-helpful__thank-you-message\" role=\"status\">\n        <i class=\"was-this-helpful__thank-you-message-icon fa fa-check\"><\/i>\n        <p class=\"was-this-helpful__thank-you-message-text\" aria-live=\"polite\"><\/p>\n    <\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"fl-section-sidebar\"><div class=\"fl-editors-summary\" data-testid=\"fl-editors-summary\">\n    \n    <div class=\"fl-editors-summary-content\" data-testid=\"fl-editors-summary-content\">\n                    <h2>Can I Solve This on My Own or Do I Need an Attorney?<\/h2>\n                <div class=\"fl-editors-summary-content-main\" data-testid=\"fl-editors-summary-content-main\">\n            \n        <\/div>\n        <ul class=\"fl-list-style-none\">\n                            <li data-testid=\"fl-editors-summary-content-item\">\n                    <i class=\"fa fa-check medium fl-editors-summary-content-item-icon\" aria-hidden=\"true\"><\/i>\n                    Most can confirm whether their group plan must cover resconstruction on their own\n\n                <\/li>\n                            <li data-testid=\"fl-editors-summary-content-item\">\n                    <i class=\"fa fa-check medium fl-editors-summary-content-item-icon\" aria-hidden=\"true\"><\/i>\n                    <span data-sheets-root=\"1\">Healthcare systems and insurance companies are well-resourced with teams of attorneys on their side<\/span>\n\n                <\/li>\n                            <li data-testid=\"fl-editors-summary-content-item\">\n                    <i class=\"fa fa-check medium fl-editors-summary-content-item-icon\" aria-hidden=\"true\"><\/i>\n                    Complex heath care cases (such as medical malpractice, bioethics, or health advocacy) may need a lawyer&#8217;s support\n\n                <\/li>\n                    <\/ul>\n                    <div class=\"fl-editors-summary-content-description\" data-testid=\"fl-editors-summary-content-description\">\n                <p>Protect your patient rights with an attorney at your side. An attorney can offer tailored advice and help prevent common mistakes.<\/p>\n\n            <\/div>\n                            <div class=\"fl-editors-summary-content-link fl-flex\" data-testid=\"fl-editors-summary-content-link\">\n                <i class=\"fa fa-angle-right medium\" aria-hidden=\"true\"><\/i>\n                <p class=\"find-attorney\"><a href=\"https:\/\/lawyers.findlaw.com\/health-health-care-law\/#USER_GEO\/?fli=esum:FL28\" target=\"_blank\" rel=\"noopener\">Find a local attorney<\/a><\/p>\n\n            <\/div>\n            <\/div>\n<\/div>\n\n\n\n<div class=\"email-subscription fl-mb30\">\n    <div class=\"email-subscription-header\">\n        <div class=\"email-subscription-header-content\">\n            <h3 class=\"fl-callout-sm fl-no-margin\">Stay Up-to-Date With How the Law Affects Your Life<\/h3>\n        <\/div>\n        <div class=\"email-subscription-header-image fl-flex fl-items-end\">\n            <img decoding=\"async\"\n                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