Breaking news! The US government now says that AFC is a type of breast reconstruction and as such must be covered by insurance alongside conventional breast reconstruction!
The US Department of Labor recently released an FAQ about the interpretation of the Women’s Health and Cancer Rights Act of 1998 (WHCRA), which is the federal law requiring most private insurance to cover the cost of breast reconstruction. Reconstruction rates soared after the passage of this bill as it became widely accessible. But the way the law is written is less than clear when it comes to flat closure, and some insurance companies have taken advantage of this ambiguity to deny coverage, particularly for flat revision surgery. This led to states taking up the cause to protect patients – first New York and then Indiana followed suit, and bills are under consideration in other states currently. Those state bills typically state clearly that “chest wall reconstruction” is to be covered alongside conventional breast reconstruction.
Now, finally, we have clear guidance from the government on this matter.
“Q: Are [insurers]… required to provide coverage for chest wall reconstruction with aesthetic flat closure as a type of breast reconstruction under WHCRA?
A: Yes… this includes coverage for chest wall reconstruction with aesthetic flat closure… as a required type of reconstruction.”
This is HUGE! Insurers will no longer be able to deny coverage for AFC services and patients will no longer have to fight their insurance companies just to get necessary care!
#aestheticflatclosure
#putflatonthemenu
