19.5.16 Breast Cancer and Mastectomies
Florida law mandates that individual, group, and out-of-state health insurance policies, multiple employer welfare arrangements and HMO contracts provide coverage for prosthetic devices and reconstructive surgery following a mastectomy, including all surgery necessary to re-establish symmetry between the breasts.
Denial or exclusion from coverage for breast cancer if the person has remained breast cancer free for two years is prohibited. Breast cancer follow-up care is also prohibited from being considered an evaluation for a preexisting condition, unless breast cancer is found.
In addition, health insurers may not refuse coverage solely because the proposed insured has been diagnosed as having a fibrocystic condition, unless the condition is diagnosed through a breast biopsy that demonstrates an increased disposition to developing breast cancer.
