2025 Kaiser Permanente EOC - Notices Regarding Your Health Plan Coverage - Women’s Health and Cancer Rights Act of 1998 - Newborn Baby and Mother Protection Act

Sep 3, 2026

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Notices regarding health plan coverage outline two federal/state mandates that apply to covered maternity and mastectomy-related care. The Women’s Health and Cancer Rights Act of 1998 requires insurance plans covering mastectomy to also cover breast reconstruction, surgery to create symmetrical appearance on the other breast, and prostheses and treatment of physical complications at all stages. The Newborn Baby and Mother Protection Act requires minimum inpatient stays after vaginal and cesarean delivery, limits how length of stay may be shortened, and specifies follow-up visit coverage. Benefits remain subject to plan terms, including copayments, exclusions, limitations, and reductions.

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Notices Regarding Your Health Plan Coverage

Women’s Health and Cancer Rights Act of 1998

Newborn Baby and Mother Protection Act

Non-Discrimination

| Notices Regarding Your Health Plan Coverage
Women’s Health and Cancer Rights Act of 1998 | | --- | | The Women’s Health and Cancer Rights Act of 1998 was passed into law on October 21, 1998. This federal law requires all health insurance plans that provide coverage for a mastectomy must also provide coverage for the following medical care:
• Reconstruction of the breast on which the mastectomy has been performed.
• Surgery and reconstruction of the other breast to produce a symmetrical appearance.
• Prostheses and treatment of physical complications at all stages ofthe mastectomy, including lymphedemas.
We provide medical and surgical benefits for a mastectomy. Covered benefits are subject to all provisions described in Your plan, including but not limited to, Copayments, exclusions, limitations, and reductions.
Newborn Baby and Mother Protection Act | | The Newborn Baby and Mother Protection Act (Code Section 33-24-58.2 of the Georgia Law) requires that health benefit policies which provide maternity benefits must provide coverage for a minimum of 48 hours of inpatient care following a normal vaginal delivery and a minimum of 96 hours of inpatient care following a cesarean section for a mother and her newborn child. The care must be provided in a licensed health care facility.
A decision to shorten the length of stay may be made only by the attending health care provider after conferring with themother. If the stay is shortened, coverage must be provided for up to two follow-up visits with specified health care providers with the first visit being within 48 hours after discharge. After conferring with the mother, the health care provider must determine whether the initial visit will be conducted at home or at the office and whether a second visit is appropriate. Specified services are required to be provided at such visits.
Covered benefits are subject to all provisions described in Your plan, including but not limited to, Copayments exclusions, limitations and reductions.
Non-Discrimination |

FAQs

What does the Women’s Health and Cancer Rights Act require regarding mastectomy coverage?

Plans that cover a mastectomy must also cover breast reconstruction, surgery to produce a symmetrical appearance for the other breast, and prostheses and treatment of physical complications at all stages, including lymphedemas.

How long must inpatient care be covered after childbirth under the Newborn Baby and Mother Protection Act?

Coverage must provide at least 48 hours of inpatient care after a normal vaginal delivery and at least 96 hours after a cesarean section for the mother and newborn in a licensed facility.

Can the inpatient stay be shortened, and what follow-up coverage is required?

The attending health care provider may shorten the stay only after conferring with the mother. If shortened, coverage must include up to two follow-up visits with specified providers, with the first visit within 48 hours after discharge.

Sep 3, 2026

Upload by Oliver