Reconstructive Surgery After Mastectomy - Kaiser State Health Facts

	Mandates Reconstructive Surgery After Mastectomy?	Notes

United States	35 + DC Yes

Alabama	No
Alaska	Yes	Women's Health and Cancer Rights Act (WHCRA) coverage requirements apply to any policy that covers mastectomies.
Arizona	Yes	Any policy that covers mastectomy must cover reconstruction.
Arkansas	Yes	WHCRA coverage requirements apply to any policy that requires covers mastectomies.
California	Yes	Any policy that covers mastectomy must cover reconstruction.
Colorado	No
Connecticut	Yes	Any policy that covers mastectomy must cover reconstruction.
Delaware	Yes	Any policy that covers mastectomy must cover reconstruction.
District of Columbia	Yes	Any policy that covers mastectomy must cover reconstruction.
Florida	Yes	Any policy that covers mastectomy must cover reconstruction.
Georgia	No
Hawaii	No
Idaho	No
Illinois	Yes	If no malignancy found, reconstruction must be performed within two years.
Indiana	Yes	Any policy that covers mastectomy must cover reconstruction.
Iowa	No
Kansas	Yes	Any policy that covers mastectomy must cover reconstruction.
Kentucky	Yes
Louisiana	Yes	Any policy that covers mastectomy must cover reconstruction.
Maine	Yes	Any policy that covers mastectomy must cover reconstruction.
Maryland	Yes	Any policy that covers mastectomy must cover reconstruction.
Massachusetts	No
Michigan	Yes	Any policy that covers mastectomy must cover reconstruction.
Minnesota	Yes	Any policy that covers mastectomy must cover reconstruction.
Mississippi	No
Missouri	Yes	Any policy that covers mastectomy must cover reconstruction.
Montana	Yes	Any policy that covers mastectomy must cover reconstruction.
Nebraska	Yes	Any policy that covers mastectomy must cover reconstruction.
Nevada	Yes	Any policy that covers mastectomy must cover reconstruction.
New Hampshire	Yes	Any policy that covers mastectomy must cover reconstruction.
New Jersey	Yes	Any policy that covers mastectomy must cover reconstruction.
New Mexico	No
New York	Yes	Any policy that covers mastectomy must cover reconstruction.
North Carolina	Yes	Any policy that covers mastectomy must cover reconstruction.
North Dakota	Yes	Women's Health and Cancer Rights Act (WHCRA) coverage requirements apply to any policy that covers mastectomies.
Ohio	No
Oklahoma	Yes	Any policy that covers mastectomy must cover reconstruction.
Oregon	Yes	Any policy that covers mastectomy must cover reconstruction.
Pennsylvania	Yes	Any policy that covers mastectomy must cover reconstruction.
Rhode Island	Yes	Any policy that covers mastectomy must cover reconstruction.
South Carolina	Yes	Any policy that covers mastectomy must cover reconstruction.
South Dakota	No
Tennessee	No
Texas	Yes	Any policy that covers mastectomy must cover reconstruction.
Utah	Yes	Any policy that covers mastectomy must cover reconstruction.
Vermont	No
Virginia	Yes	Any policy that covers mastectomy must cover reconstruction.
Washington	No
West Virginia	Yes	Any policy that covers mastectomy must cover reconstruction.
Wisconsin	Yes	Any policy that covers mastectomy must cover reconstruction.
Wyoming	No

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Notes:	Data as of March 15, 2008. States are noted if they provide broader coverage for reconstructive surgery following a mastectomy than is required by federal law under WHCRA. Reconstructive surgery includes, but is not limited to, augmentation mammoplasty, reduction mammoplasty, and mastopexy. These requirements apply to managed care organizations and to the large group market (50+ employees) only.
Sources:	Health Policy Tracking Service, a service of Thomson West, available at http://www.netscan.com.
Definitions:	WHCRA: The Women's Health and Cancer Rights Act (WHCRA) sets minimum federal standards for coverage of reconstructive surgery following a mastectomy. The law requires group health plans that provide medical and surgical mastectomy benefits to also provide coverage for reconstruction of the breast on which the mastectomy has been performed; surgery and reconstruction of the other breast to produce a symmetrical appearance; and prosthesis and treatment for physical complications during all stages of mastectomy, including lymphedemas in a manner determined by the attending physician in consultation with the patient.

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