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Mother’s Day kicked off National Women’s Health Week 2017, an observance led by the U.S. Department of Health and Human Services Office on Women’s Health, and this year’s theme focuses on steps women can take for better health at every age.
It’s probably no surprise that visiting a doctor or nurse for a well-woman visit and preventive screenings made the short list of recommendations. Chronic diseases are responsible for 7 of 10 deaths among Americans each year, and they are often mostly preventable. However, studies show that cost sharing, which includes copayments, coinsurance and deductibles, results in fewer women obtaining recommended preventive care such as mammograms and Pap smears.
With that in mind, the Affordable Care Act was designed to help make preventive care affordable and accessible for all Americans. The law requires most major medical health insurance plans, including employer-sponsored health plans Obamacare plans sold on and away from state-based and federally facilitated exchanges, to cover recommended preventive services without cost-sharing.
As of Aug. 1, 2012, the Affordable Care Act required most health insurance plans to cover women’s preventive services (e.g., screenings, counseling, immunizations) at no additional cost beyond plan premium. There are now 24 covered preventive services, which include the following:
1. Anemia screening on a routine basis for pregnant women or women who may become pregnant
2. Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
3. Breast cancer genetic test counseling (BRCA) for women at higher risk for breast cancer
4. Breast cancer mammography screenings every 1 to 2 years for women over 40
5. Breast cancer chemoprevention counseling for women at higher risk
6. Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
7. Cervical cancer screening for sexually active women
8. Chlamydia infection screening for younger women and other women at higher risk
9. Contraception – Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.”
10. Domestic and interpersonal violence screening and counseling for all women
11. Expanded tobacco intervention and counseling for pregnant tobacco users
12. Folic Acid supplements for women who may become pregnant
13. Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
14. Gonorrhea screening for all women at higher risk
15. Hepatitis B screening for pregnant women at their first prenatal visit
16. HIV screening and counseling for sexually active women
17. Human Papillomavirus (HPV) DNA Test every 3 years for women with normal cytology results who are 30 or older
18. Osteoporosis screening for women over age 60 depending on risk factors
19. Rh incompatibility screening for all pregnant women and follow-up testing for women at higher risk
20. Sexually transmitted infections counseling for sexually active women
21. Syphilis screening for all pregnant women or other women at increased risk
22. Tobacco use screening and interventions for all women, and expanded counseling for pregnant tobacco users
23. Urinary tract or other infection screening for pregnant women and women who may become pregnant
24. Well-woman visits to get recommended services for women under 65
You must receive these services from a provider within your health insurance plan network; otherwise, they may not be covered. Physicians recommend preventive services at certain times and frequencies based on a woman’s group, medical history, family health history and other factors. The Office on Women’s Health offers an interactive, age-group-based guide on steps you can take in your daily life for better health in every decade.
Without insurance, women (and anyone else) may find themselves paying entirely out of pocket for recommended preventive care. Walk-in clinics and community clinics may offer access to lower-cost healthcare—and, potentially, free—for those who qualify and have access to such clinics.
Women who do not qualify for a special enrollment period may find themselves uninsured until next open enrollment period—and, even then, their Obamacare plan will not take effect until Jan. 1 of the new year or later, depending on when they enrolled. Women who meet their state’s criteria may be eligible for Medicaid, which is available year-round.
Other women may want to consider temporary coverage in the form of a short term health plan until they can start an ACA-compliant Obamacare plan. Short term plans are not ACA-compliant; they are not guaranteed issue, which means you can be denied coverage based on your health history, and they will not prevent you from owing the individual shared responsibility payment (i.e., Obamacare tax penalty) if you are not exempt from coverage. However, they do provide a range of benefits to help pay for covered medical expenses, and some short term plans even cover a few preventive care services. You may choose a policy length of 30 days to 364, depending on the state where you live.
Buying short term benefits can be a new experience for many people. You can work with a health insurance producer,such as the certified advisors available through healthedeals.com, to learn more about temporary coverage options and customize a plan to meet your needs.
For more tips on paying for healthcare when you are uninsured, read “How to Get (and Pay for) Healthcare When You are Uninsured.
Supplemental coverage such as dental insurance, medical gap insurance and critical illness coverage can help reduce what you and your family pay out of pocket for healthcare—healthcare your Obamacare plan doesn’t cover. Plans start at less than a dollar per day.
Call the number at the top of your screen to speak with someone who can answer your questions and discuss your options—no pressure to buy, just friendly expertise.
Originally posted May 5, 2016.
 U.S. Department of Health and Human Services. “Affordable Care Act Rules on Expanding Access to Preventive Services for Women.” Posted Aug. 1, 2011. http://www.hhs.gov/healthcare/facts-and-features/fact-sheets/aca-rules-on-expanding-access-to-preventive-services-for-women/index.html