Facing a breast cancer diagnosis is overwhelming enough—wondering whether breast reconstruction is covered by insurance shouldn’t add to the burden. This question arises early in the journey for many women, often layered with confusion, fear, and financial concern. The good news? You have rights—and they’re protected by federal law.

Whether you’re choosing immediate reconstruction or considering your options after treatment, coverage is not optional—it’s your right.

Yes—Breast Reconstruction Is Covered by Insurance

Thanks to the Women’s Health and Cancer Rights Act (WHCRA) of 1998, health insurance companies that cover mastectomy procedures are required by law to also cover breast reconstruction, both immediate and delayed. This includes methods to restore symmetry, treat complications, and even address reconstruction of the opposite breast for balance. 

What’s Typically Covered Under Breast Reconstruction Laws?

Under WHCRA, most group health plans that offer mastectomy coverage are required to cover several key aspects of breast reconstruction, whether performed immediately or at a later date. This ensures that women have the opportunity to restore not just form, but symmetry, comfort, and dignity.

Here’s what’s typically included:

• Reconstruction of the breast removed by mastectomy—whether you choose to rebuild right away or wait until you’re ready.
• Surgery on the opposite breast to achieve a balanced, symmetrical appearance.
• External breast prostheses—for women who opt not to undergo reconstruction.
• Post-surgical bras and garments—often, insurance covers these essential support tools during healing.

This coverage helps eliminate financial barriers so you can focus on what truly matters: reclaiming your body and your confidence on your terms. 

Does It Matter When You Have Breast Reconstruction After a Mastectomy?

Under the WHCRA, the timing of your breast reconstruction does not affect your right to insurance coverage. Whether you choose to rebuild your breast immediately after mastectomy or years down the line, your protections remain the same.

In fact, many of our patients come to us months—or even years—after their initial surgery. Fortunately, our surgeons specialize in delayed breast reconstruction, including cases following radiation, implant complications, or personal timing preferences. 

We’ll guide you through the entire process, from selecting the best reconstructive option to navigating insurance, so you feel supported, confident, and in control every step of the way.

What About Insurance Approvals and Providers?

While the law ensures that breast reconstruction is covered, most plans still require pre-authorization before surgery can take place. This rule means your provider must review and approve the procedure in advance, so starting the conversation early is important.

Additionally, insurance plans typically require that your plastic surgeon is in-network to receive full coverage benefits. Not all reconstructive surgeons are covered by every plan, so verify network status when selecting your surgical team.

Choosing a board-certified reconstruction surgeon is also essential. That’s why all of our surgeons are board-certified specialists in breast reconstruction with decades of combined experience in advanced techniques like DIEP flap and TruSense® sensation restoration. Our team works closely with patients and insurance providers to streamline approvals and eliminate surprises—so you can focus on healing, not paperwork.

Talk to PRMA About Your Insurance and Options

Breast reconstruction isn’t just about restoring what was lost—it’s about reclaiming your sense of self. Thanks to the Women’s Health and Cancer Rights Act, insurance coverage for reconstruction is your legal right—whether you choose surgery right after your mastectomy or years later.

From covering reconstruction on both breasts to providing external prostheses and post-surgical garments, the law is on your side. The surgeons at PRMA are here to ensure you receive the expert care you deserve, without unnecessary barriers or stress.

If you’re considering breast reconstruction, even if it’s been months or years since your mastectomy, we encourage you to reach out for a consultation. It’s never too late to explore your options, and you don’t have to navigate this journey alone. Let PRMA help you take the next step toward healing, confidence, and wholeness.