Human Resource Blog

WHCRA in Alabama

What is important with regards to the WHCRA in Alabama?

The Womens Health and Cancer Rights Act is a federal Act that applies to health care coverage companies around the country, including in states such as Alabama. Under the Act, health care coverage companies are required to provide health care coverage for additional treatments as long as they already provide coverage for the cost of a mastectomy.

According to WHCRA, the mastectomy is the qualifying event that calls for additional benefits. However, if a company offers those additional benefits aside from the mastectomy, they are not required by the WHCRA. Only when the benefits are associated directly with the mastectomy are they required by the WHCRA.

WHCRA is an Act that applies in large part to the health care coverage providers and not as much to the employers. However, the Act does prohibit employers from bribing a health care professional to decrease the coverage that is extended to employees in order to save the company money.

The WHCRA also requires that health care providers that are covered under the Act send out an annual notice to qualifying policy holders to let those policy holders know about the rules of the Act. Those health care coverage providers might be health insurance companies, group health care plans or even Health Maintenance Organizations.

The WHCRA ensures that when a policy holder has a mastectomy, the policy holder will also be able to have the following related treatments:

·         Coverage for the cost of reconstructive surgery of the breast on which the mastectomy has been performed

·         Any additional coverage that may be needed to create a symmetrical appearance between the two breasts

·         The implantation of a prosthetic breast, including the cost of the purchase of the prosthetic breast

·         Treatment for complications that could arise from the surgeries

·         Treatment for conditions that could arise from the surgeries, such as lymphoma. CB