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June 20, 1980

Insurance Coverage for Breast Reconstruction-Reply

Author Affiliations

Cleveland Clinic
University of Wisconsin Madison
East Virginia Medical School Norfolk

JAMA. 1980;243(23):2398. doi:10.1001/jama.1980.03300490016015

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In Reply.—  We did not advocate legislative control of insurance except as a last resort. Legislation might not be necessary if insurance carriers take the responsibility of including breast reconstruction as an indisputable part of all standard policies. Breast reconstruction is not different from the restoration of other body parts treated for cancer and must be included in standard health insurance contracts. Unfortunately, breast reconstruction is the only major reconstructive operation that still requires prior written approval.It is not appropriate to place the burden of change on women who are not included in negotiation of group contracts. It is also wrong to presume that consumers have the medical awareness to define adequate insurance policies. Many women are unaware that their policies deny them breast reconstruction and are not free to change to a different insurance carrier's policy.Women who have or in whom breast cancer may develop should not