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Annual Notification of Health Coverage for Reconstructive
Surgery Following Mastectomy
Federal and State of Illinois laws require that
individuals covered by a group health plan be notified
yearly of the provisions of the Women’s Health
and Cancer Rights Act. HMO Illinois, BlueAdvantageSM
HMO, BlueChoice® and Point of Service
members will receive the notification in their newsletters.
The notice (see sidebar) is also posted on the member
pages of our Web site.
December 2004 Deadline
Please note that it is the responsibility of group
administrators and producers to provide this notice
or a similar version to all Blue Cross and Blue
Shield of Illinois PPO and indemnity members by
December 31, 2004. Also, this notice must be included
in enrollment materials if a group does not use
enrollment materials produced by BCBSIL. To assist
you, we have prepared this notice, which explains
the law’s provisions.
To receive the notice electronically, contact waldenb@bcbsil.com.
For more information about these laws, contact your
General Agent or Blue Cross representative.
Benefits for Reconstructive
Surgery and Mammograms
Federal and State of Illinois laws require
group health plans and insurers to provide
coverage for reconstructive surgery following
a mastectomy. These laws state that health
plans that cover mastectomies must also provide
coverage in a manner determined in consultation
with the attending physician and patient for:
reconstruction of the breast on which
the mastectomy has been performed surgery and reconstruction of the other
breast to produce a symmetrical appearance prostheses and treatment for physical
complications for all stages of mastectomy,
including lymphedemas
Blue Cross and Blue Shield of Illinois is
pleased to provide coverage for mastectomies
and the above procedures, subject to the terms
of the member’s applicable health care
benefits coverage.
Your coverage may also include benefits for
annual mammograms. See your Certificate/benefit
booklet or call Blue Cross at the phone number
on the back of your ID card.
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