If you underwent a mastectomy and your health insurance company
denied a subsequent breast reconstruction or revision surgery, you may have the right to challenge the denial. Our health insurance denial lawyers represent individuals and families across the United States whose insurers wrongfully refuse to pay for necessary post-mastectomy treatment.
Insurance companies deny initial reconstruction, revision surgery, symmetry procedures, and related care following a mastectomy citing reasons such as:
“Cosmetic”
“Not medically necessary”
“Elective”
“Not reconstructive”
“Not covered under the plan”
Under the Women’s Health and Cancer Rights Act (WHCRA), most group health plans that cover mastectomies must also cover breast reconstruction and related procedures, including surgery on the unaffected breast to achieve symmetry, treatment of complications, and prostheses. When insurers refuse to cover these services, they may be violating the law. Our attorneys investigate these cases and pursue legal action when appropriate.
Contact Us
If you or someone you know was denied coverage for breast reconstruction or revision surgery following a mastectomy, we encourage you to submit information through our intake form.
If possible, please include the following information:
- Full Name
- Email Address
- Phone Number
- State of Residence
- What insurance do you have this issue with? (List insurer, plan name, whether obtained through employer, marketplace, or other. If you know whether your plan is ERISA-governed, please note that too.)
- Was your mastectomy performed due to cancer or prophylactically?
- What procedure was denied? (e.g., initial reconstruction, revision surgery, symmetry surgery, nipple reconstruction, tattooing, etc.)
- What was the reason for the denial? (e.g., “cosmetic,” “not medically necessary,” etc.)
- Did you file an appeal? (If yes, please describe the result.)
- Anything else you think we should know.
The more detail you provide, the more efficiently our team can evaluate your potential claim.
Legal Notices & Disclaimers
This website is for informational purposes only and may be considered attorney advertising. Prior results do not guarantee a similar outcome.
Our attorneys are admitted to practice law in Florida, New York, and the District of Columbia. We represent clients in other jurisdictions in accordance with applicable ethical rules and court requirements, including, when necessary, working with local counsel or seeking pro hac vice admission.
Submitting information through this website or completing our intake form does not create an attorney–client relationship. A formal attorney–client relationship is created only after we review your submission, determine that we can assist, and both you and the firm execute a written engagement agreement.
The information on this page is provided for general informational purposes only and is not legal advice. You should not rely on this information as a substitute for seeking advice from a licensed attorney regarding your specific situation.