MMC Benefits Handbook
Mastectomy – Reconstructive Surgery
Does the Plan cover mastectomy-related services?
NOTE: Out-of-network services are not covered under the Anthem BCBS Narrow Network (National Blue High Performance Network (Blue HPN Non-Tiered)) except for urgent and emergency care.
Yes, the Plan covers mastectomy-related services. Coverage will be provided in a manner determined by the attending physician and the patient. The covered services include:
- All stages of reconstruction of the breast on which the mastectomy was performed,
- Surgery and reconstruction of the other breast to produce a symmetrical appearance,
- Prostheses, and
- Treatment of physical complications of the mastectomy, including lymphedema.
What are the applicable deductibles and coinsurance for mastectomy-related benefits under the Plan?