{"id":355853,"date":"2016-04-04T10:46:17","date_gmt":"2016-04-04T15:46:17","guid":{"rendered":"https:\/\/content.findlaw-admin.com\/ability-law\/healthcare\/patient-rights\/womens-health-and-cancer-rights-act-overview.html"},"modified":"2023-06-26T09:23:07","modified_gmt":"2023-06-26T14:23:07","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’s Health and Cancer Rights Act?"},"content":{"rendered":"\n
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What is the Women's Health and Cancer Rights Act?<\/h1>\n
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\n By Melissa McCall, J.D.<\/a> | Legally reviewed by Aviana Cooper, Esq.<\/a>\n | Last updated\n
\n \n <\/i>\n Legally Reviewed\n <\/summary>\n\n
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This article has been written and reviewed for legal accuracy, clarity, and style by FindLaw\u2019s team of legal writers and attorneys<\/a> and in accordance with our editorial standards<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n\n

\n \n <\/i>\n Fact-Checked\n <\/summary>\n\n
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The last updated date refers to the last time this article was reviewed by FindLaw or one of our contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please contact an attorney in your area<\/a>.<\/em><\/p>\n\n <\/div>\n <\/details>\n<\/section>\n

The Women’s Health and Cancer Rights Act (1998), or WHCRA, is a federal law that provides certain protections to breast cancer patients who want breast reconstruction surgery. Under the WHCRA<\/a>, all group health plans that cover mastectomies must provide coverage for reconstructive surgery and any other post-mastectomy benefits.<\/p>\r\n

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>\r\n

The Women’s Health and Cancer Rights Act<\/a> amends the Employee Retirement Income Security Act (ERISA)<\/a> of 1974. ERISA identifies administrative standards for employers who offer group plans. This includes health insurance or retirement plans.<\/p>\r\n

This article explores the Women’s Health and Cancer Rights Act.<\/p>\r\n

The Women’s Health and Cancer Rights Act<\/h2>\r\n

Congress passed the WHCRA after a health insurance company refused to cover reconstructive surgery for a breast cancer patient. This 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 " insured " or "self-funded" plans.<\/p>\r\n

Health Insurance Basics<\/h3>\r\n

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 healthcare items or services provided under a health insurance plan<\/a>.<\/p>\r\n

Mastectomies and Breast Reconstruction<\/h3>\r\n

A mastectomy is a surgical procedure that removes breast tissue<\/a> to treat or prevent breast cancer. With some mastectomies — called "simple" or "total" mastectomies — a surgeon removes all the breast tissue.<\/p>\r\n

Breast reconstruction is a surgery that rebuilds the breast<\/a> to give an appearance like the breast pre-mastectomy. Reconstructive surgery can take place concurrently or at some point after surgery.<\/p>\r\n

Women choose breast reconstruction for many reasons, including the following:<\/p>\r\n