A mastectomy is a serious event for any woman. Knowing exactly what type of insurance coverage you have is another matter. Cancer plans come in 2 basic forms and these will vary with each insurance company.
First, you have Comprehensive type plans that will pay a set lump sum on first diagnosis and then additional benefits: daily hospital benefit, chemotherapy, radiation, home health care, and reconstructive surgery. These are just a few examples of additional benefits and there could be more depending upon the policy selected.
Second, you have Lump Sum type plans that pay only a lump sum upon first diagnosis. Lump sum plans can pay out a much higher amount upon first diagnosis: up to $50,000. You can then utilize the funds to cover whatever services you want.
How will your health insurance plan cover reconstructive surgery? In 1998 a Federal mandate, (WHCRA) Women’s Health and Cancer Rights Act was passed. In practically all cases of Group coverage this mandate requires the insurance company to cover reconstructive surgery. As far as individual insurance coverage there are few plans that will cover this. Know what you are buying!
Now there is the matter of pre-existing conditions. This applies to all of the insurance types above and even group health insurance in certain cases. There are other types of insurance plans that will pay for cancer diagnosis and will pay in addition to a cancer plan: Critical Illness and Hospital Indemnity plans for example.
Following are some important links to further educate yourself regarding mastectomy and reconstructive surgery:
My Best to you,
American Insurance Resources