Health Care Reform: Women's Preventive Care

April 12, 2019

 

 

The Affordable Care Act (ACA) requires health plans to cover certain preventive care services for participants without any cost-sharing such as deductibles, copayments or coinsurance. This requirement includes additional preventive care for women.

 

 


Under the ACA, more types of preventive care must be provided to women than men at no extra cost. This is because women have unique health needs and higher rates of chronic diseases, such as diabetes, heart disease and stroke.

 

What Is Covered?
Health plans must cover certain additional preventive services with no copay, coinsurance or deductible required from the patient, even if the yearly deductible hasn’t been met. The following items are included in this coverage:

  • Well-woman visits (annual preventive care visits in which women under 65 obtain recommended preventive services)

  • Gestational diabetes screenings for women 24 to 28 weeks pregnant, and women who are considered high risk

  • Human papillomavirus (HPV) testing for women aged 30 and older, once every three years

  • Annual counseling for HIV and sexually transmitted infections, plus annual HIV testing for all sexually active women

  • Contraceptives and contraceptive counseling. (Certain religious employers, such as churches, are not required to cover contraceptives)

  • Breast-feeding support, supplies and counseling

  • Domestic violence screening and counseling

 

A full list of preventive health services for women is available here.

 

Under the ACA law, more types of preventive care must be provided to women than men, at no extra cost.

 

Be sure to check your plan’s specific rules before receiving care. The preventive care rules do not apply to health plans that have “grandfathered” status under the ACA.



Though plans are required to provide these services free of charge, they do have the option of using cost-control measures, such as requiring that a patient pays for a brand name drug even if a comparable generic drug is available, or charging a copayment for preventive services received at out-of-network facilities.

This article is provided by Allegeant LLC. It is to be used for informational purposes only and is not intended to replace the advice of an insurance professional. Visit us at www.allegeant.net.

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