Under WHCRA, may group health plans, insurance companies or HMOs impose deductibles or coinsurance requirements on the coverage specified in WHCRA?
Yes, but only if the deductibles and coinsurance are consistent with those established for other benefits under the plan or coverage. I just changed jobs and am enrolled under my new employer’s plan. Under my previous employer’s plan I underwent a mastectomy and chemotherapy treatment, which are not completed. I want reconstructive surgery. Under WHCRA, is my new employer’s plan required to cover my reconstructive surgery? If your new employer’s plan provides coverage for mastectomies and if you are receiving benefits under the plan that are related to your mastectomy, then your new employer’s plan generally will be required to cover reconstructive surgery if you request it. In addition, your new employer’s plan generally is required to cover other benefits specified under WHCRA. It does not matter that your new employer’s plan did not provide coverage for your mastectomy. However, a group health plan provision may limit benefits relating to a condition that was present before your enr
Related Questions
- Under WHCRA, may group health plans, insurance companies and HMOs impose deductibles or coinsurance requirements for reconstructive surgery in connection with a mastectomy?
- Does WHCRA require all group health plans, insurance companies and HMOs to provide reconstructive4 surgery benefits?
- May group health plans impose deductibles or coinsurance requirements on the coverage specified in WHCRA?
