If you have lymphedema as a result of the treatment for your breast cancer, you may be covered by your health insurance for treatment of this condition with Manual Lymphatic Drainage (MLD).

According to the, “Women’s Health And Cancer Rights Act of 1998” health plans are required to provide coverage for: 1) reconstruction of the breast following mastectomy; 2) surgery and reconstruction of the other breast to produce a symmetrical appearance; and 3) prosthesis and physical complications of mastectomy, including lymphedema. Such coverage may be subject to annual deductibles and co-insurance provisions.

Lymphedema is the accumulation of lymphatic fluid in your body’s tissues. In the case of cancer, this can occur following: cervical/ovarian procedures, lymph node dissection, radical hysterectomy, modified or radical mastectomies. The pathway for this fluid to normally recirculate has been disrupted and, therefore, the fluid accumulates. This can occur in the breast, chest, abdomen, arm or leg Left untreated, lymphedema can continue to progress. The patient might experience a subtle sense of “fullness” in the tissues, a gradual hardening (fibrosis) of the tissues, pitting of the skin, enlargement of the area, discoloration and poor wound healing.

Lymphedema can be effectively treated with a technique called MLD. This technique involves gentle, directional strokes over the affected tissue to encourage the lymph fluid to find a route of exit from the congested tissues.

This technique has proven so effective in Europe that it is routinely scheduled immediately following surgery with a doctor’s approval. Currently in the United States, a law insures this treatment be provided, however, very few patients are aware of this benefit and endure the physical and emotional trials of this treatable condition.

If you would be interested in discussing or scheduling a treatment for yourself, please contact me. I would be happy to answer any of your questions, and verify your insurance coverage.

WOMEN’S HEALTH, CANCER RIGHTS ACT OF 1998
New Federal legislation entitled the “Women’s Health and Cancer Rights Act of 1998” requires health plans to provide coverage for reconstructive and related surgery following a mastectomy (surgical removal of breast tissue). If breast reconstruction following a mastectomy for cancer is currently a covered benefit under your health care plan medical option, this notice is intended to inform you of the new law and to clarify post-mastectomy breast reconstruction surgery and related procedure coverage beginning January 1, 1999. This new coverage requirement is effective on the first day of the plan year beginning on or after October 21, 1998.

This law requires fully insured and self-insured group health plans that provide medical and surgical mastectomy benefits to also provide coverage for: 1)reconstruction of the breast on which the mastectomy has been performed; 2)surgery and reconstruction of the other breast to produce a symmetrical appearance; and 3)prothesis and physical complications during all stages of mastectomy, including lymphededemas (lymphatic swelling). As with all coverage under various health plan medical options, this coverage may be subject to annual deductibles and coinsurance provisions.