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UFCW LOCAL 1776 and
PARTICIPATING EMPLOYERS HEALTH and WELFARE FUND |
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Mastectomies And Reconstructive Surgery Under federal law, group health plans that provide medical and surgical benefits in connection with a mastectomy must provide benefits for certain reconstructive surgery effective January 1, 1999. In accordance with federal law, the Plan pays for mastectomy-related services including reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, and prostheses and treatment of physical complications at all stages of mastectomy, including lymphedemas. This coverage will be provided in a manner determined in consultation with the attending physician and the patient, subject to the general provisions of the applicable medical coverage relating to benefits, pre-certification and other applicable limitations, including annual deductibles, co-payments and coinsurance provisions. If you have any questions about mastectomies and reconstructive surgery under your medical coverage, please contact the Fund office. Benefits For Mothers And Newborns Under your medical coverage, and as required by law, the
Plan generally may not restrict benefits for any hospital length of stay in
connection with childbirth for the mother or newborn child to less than 48
hours following a vaginal delivery, or less than 96 hours following a cesarean
section. However, these requirements
generally do not prohibit the mother's or newborn's attending provider, after
consulting with the mother, from discharging the mother or her newborn earlier
than 48 hours (or 96 hours as applicable). In any case, the Plan may not
require that a provider obtain authorization from the Plan for prescribing a
length of stay not in excess of 48 hours (or 96 hours). |