This article is intended for HMO members enrolled in an employer health insurance plan.

A mastectomy is the removal of one or both breasts. This procedure is most often performed to treat breast cancer.

If you are facing this surgery, take some comfort in the fact that federal and state laws require insurance companies to cover reconstructive surgery afterward.

Blue Cross and Blue Shield of Illinois (BCBSIL) provides coverage for:

  • Recreating the breast that was removed
  • Breast implants
  • Surgery on the other breast for an even appearance
  • Treatment of possible side effects of mastectomy, including lymphedema (fluid buildup that leads to swelling)

These procedures must be provided by a licensed physician and meet other requirements.

Your plan may also cover annual mammograms. Want to find out more? Just call us at the toll-free number on the back of your BCBSIL member ID card.