A group health plan covers mastectomies. Under the Women's Health and Cancer Rights Act, the plan must also cover:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
The federal Women's Health and Cancer Rights Act (WHCRA) requires group health plans and insurers that cover mastectomies to also provide coverage for breast reconstruction following the mastectomy. Covered services include reconstruction of the breast on which the mastectomy was performed, surgery on the other breast to achieve symmetry, and prostheses, along with complications from the mastectomy. The protection applies to reconstructive care, not to purely elective cosmetic procedures chosen for personal preference. WHCRA thus establishes a required coverage, not a general entitlement to cosmetic surgery.
Why the other options are wrong
- B) Cosmetic breast augmentation is an elective procedure unrelated to cancer treatment and is not required by the Women's Health and Cancer Rights Act.
- C) Annual full-body cosmetic procedures are not a medical necessity and are not mandated by WHCRA or any federal health benefit law.
- D) Implants chosen purely for personal preference are cosmetic and elective, so they are not covered under the reconstruction requirement.
Memory hook
WHCRA: mastectomy care includes rebuilding. Reconstruction, not cosmetic wishes, is the mandate.