Healthcare Reform and Women's Health Preventive Services: What is Now Cost-Free to the Patient?

Healthcare Reform and Women's Health Preventive Services: What is Now Cost-Free to the Patient?
Healthcare Reform and Women's Health Preventive Services: What is Now Cost-Free to the Patient?

National data show that women are more likely to be uninsured, and when they have insurance, can pay premiums up to 84% higher than men who are receiving the same coverage. The lack of insurance and higher out-of-pocket costs are contributing factors to a decline in receiving regular preventive care amongst women. The Affordable Care Act contains a provision that forces private insurance companies to make certain preventive services (e.g., mammograms, screenings for cervical cancer, prenatal care, and other services) available without co-pays, co-insurance, or deductibles.

Beginning August 1, 2012, the following women's preventive services must now be covered by every new health plan, with no cost sharing for the patient. Non-grandfathered plans and issuers must provide coverage without cost sharing, consistent with these guidelines in the first plan year (in the individual market, policy year) that begins on or after August 1, 2012.  

Preventive Service

Included in Service

Frequency

Well-Woman Visits

All age- and developmentally-appropriate preventive services, including:

  • Preconception and prenatal care
  • For high-risk women: breast cancer counseling about genetic testing and chemoprevention
  • Mammography every 1–2 years for women >40 years
  • Tobacco-use screening and interventions

Annually for women <65 years of age

Contraception

  • FDA-approved contraceptive methods, sterilization procedures, patient education, and counseling for all women with reproductive capability (excludes abortifacient drugs)

As prescribed

HPV testing

  • High-risk HPV DNA testing in women with normal cytology results

Begin at 30 years of age, every 3 years

STI/HIV Counseling and Screening

  • Screening and counseling for all sexually active women for cervical cancer, chlamydia, gonorrhea, and HIV

Annually

Pregnant-Woman Screenings

  • Screening for anemia, bacteriuria, hepatitis B virus, Rh incompatibility, and syphilis. Folic acid supplements provided.

Regular screening at routine prenatal visits. Hepatitis B screening at first prenatal visit

Gestational Diabetes Screening

  • Screening for gestational diabetes

Women at high risk, and those at 24—28 weeks of gestation

Breastfeeding Support

  • Lactation support by a trained provider, costs for renting breastfeeding equipment

During pregnancy and postpartum period with each birth

Osteoporosis Screening

  • Bone-density testing

Begin at 60 years of age, every 2 years

Interpersonal and Domestic Violence Support

  • Screening and counseling

Annually



 

REFERENCES
Health Care Reform and Preventive Care for Women. Sargent Shriver National Center on Poverty Law. Available at: http://www.povertylaw.org/news-and-events/woman-view/preventivecare. Accessed August 9, 2012.

Preventive Services Covered Under the Affordable Care Act. Healthcare.gov.
http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html#CoveredPreventiveServicesforWomenIncludingPregnantWomen. Accessed August 1, 2012.

Women's Preventive Services: Required Health Plan Coverage Guidelines. U.S. Department of Health and Human Services. http://www.hrsa.gov/womensguidelines/. Accessed August 1, 2012.