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Reconstructive Surgery Following a Mastectomy

Federal and State of Illinois legislation require group health plans and health insurers provide coverage for reconstructive surgery following a mastectomy. Specifically, 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; and
  • Prostheses and treatment for physical complications for all stages of mastectomy, including lymphedemas.

Blue Cross and Blue Shield of Illinois (BCBSIL) provided this coverage before it was required. We are pleased to continue providing coverage for mastectomies and the above procedures, subject to the terms of the member’s applicable health care benefits coverage.

The BCBSIL coverage now being offered to you may also include benefits for baseline and annual mammograms. See your enrollment materials or certificate of health care benefits or contact Blue Cross and Blue Shield of Illinois for details.