
Insurance coverage for aesthetic flat closure in the state of Wisconsin
632.895 Mandatory coverage.
(13) Breast reconstruction.
(a) Every disability insurance policy, and every self-insured health plan of the state or a county, city, village, town or school district, that provides coverage of the surgical procedure known as a mastectomy shall provide coverage of breast reconstruction of the affected tissue incident to a mastectomy.
(b) The coverage required under par. (a) may be subject to any limitations, exclusions or cost-sharing provisions that apply generally under the disability insurance policy or self-insured health plan.
Proposed Amendment:
632.895 Mandatory coverage.
(13) Breast or chest wall reconstruction.
(a) Every disability insurance policy, and every self-insured health plan of the state or a county, city, village, town or school district, that provides coverage of the surgical procedure known as a mastectomy shall provide coverage of breast or chest wall reconstruction of the affected tissue incident to a mastectomy.
(b) The coverage required under par. (a) may be subject to any limitations, exclusions or cost-sharing provisions that apply generally under the disability insurance policy or self-insured health plan.
(c) Chest wall reconstruction surgery shall include aesthetic flat closure as such term is defined by the National Cancer Institute.
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