8 health insurance benefits to ask for after breast cancer
A breast cancer diagnosis doesn’t just affect your body. It changes how you move through the world, how you spend your time, and what you need to feel okay. But in the midst of all that, it can also open the door to support you never expected. From mental health care to wellness therapies, your insurance may cover more than you realize including care that helps you feel more like yourself again.
Beyond the expected scans and prescriptions, many plans will cover services that support your recovery and overall well-being. These lesser-known benefits can make a big difference in how you feel, physically and emotionally, during and after treatment.
1) Post-surgical bras & prostheses
If you’ve had a mastectomy or lumpectomy, most insurance companies are legally required (thanks to the Women’s Health and Cancer Rights Act) to cover mastectomy bras, breast prostheses, and a reconstruction option of your choice. You may be eligible for multiple bras per year so don’t settle for just one.
Pro tip: Ask your doctor for a prescription with detailed language like “post-mastectomy bra with pocket for prosthesis” to ensure proper coverage. And check out the insurance resources from AnaOno for more information.
2) Massage therapy
Lymphedema risk? Chronic pain? Many plans cover manual lymphatic drainage massage or other therapeutic bodywork when it’s deemed medically necessary.
Pro tip: Get a referral from your oncologist or physical therapist specifically mentioning the reason (like lymphedema management or radiation induced tightness in your muscles).
3) Acupuncture
From nausea and fatigue to anxiety and hot flashes, acupuncture has shown proven benefits and some insurers now recognize the data and provide coverage for a set amount of acupuncture sessions. If your oncologist supports it, you may get partial or full coverage, especially through integrative oncology programs.
Pro tip: Look for in-network practitioners with oncology experience, and check if a referral is needed.
4) Nutrition counseling
Cancer changes your body and your nutritional needs. Insurance often covers registered dietitian consults, especially if you’re dealing with weight loss, GI issues, or are on a special treatment like chemo or hormonal therapy.
Pro tip: Look for a dietitian with an oncology specialty, and ask your oncologist to note malnutrition risk or weight management on the referral.
5) Mental health services
Whether you’re dealing with scanxiety, relationship changes, or the trauma of diagnosis, mental health support is critical. Under the Mental Health Parity Act, it’s likely your insurance must offer comparable coverage for mental health services as it does for physical health.
For an easy and accessible way to access therapy, online therapy platforms like Talkspace can provide convenient mental health support by connecting you with a licensed therapist. Talkspace is in-network with most insurance plans or you can use the code OUTCOMES4ME100 for $100 off your first month through our partnership.
Pro tip: Ask your oncology social worker to help you find in-network providers who specialize in cancer-related mental health support.
6) Pelvic floor therapy
This may sound surprising but the benefits of this type of therapy are well established in oncology care. Treatments like chemotherapy, early menopause, or surgical menopause can affect your pelvic health. If you’re experiencing pain, bladder issues, or intimacy challenges, pelvic floor PT might be covered.
Pro tip: Frame your request around “pelvic dysfunction related to cancer treatment” and ask for a referral from your gynecologist or PCP.
7) Fertility preservation
If you’re pre-menopausal and newly diagnosed, some states require insurance to cover egg or embryo freezing. Even if you’re post-treatment, hormonal changes may still entitle you to coverage for fertility consults or hormone support.
Pro tip: Check your state laws and ask for a time-sensitive oncology referral for reproductive endocrinology services.
8) Transportation or lodging for treatment
Some plans offer coverage or reimbursement for travel to major cancer centers, especially for clinical trials or second opinions.
Pro tip: Call your insurer’s member care team and ask if they have a travel or case management benefit.
How to navigate the insurance process
Getting these services approved isn’t automatic. Here’s how to improve your odds:
- Get a referral. Most insurers require a provider’s note or prescription, even if the service seems “alternative.”
- Use the right language. “Medically necessary,” “treatment-related,” and “symptom management” go a long way in unlocking coverage.
- Ask for a case manager. Some insurers will assign you a nurse case manager who can help you navigate approvals and appeals.
- File an appeal. If your claim is denied, you have the right to appeal and it often takes multiple times. Don’t give up on the first “no.”
_____________________________________________
At Outcomes4Me, we believe knowledge is power, especially when it comes to advocating for your care. Our app makes it easier to understand what’s available to you, track your symptoms, explore clinical trials, and connect to vetted resources. We’re here to help you take control of your breast cancer care every step of the way.
