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What Preventive Care Services Does Health Insurance Cover for Women?

What Preventive Care Services Does Health Insurance Cover for Women?

Posted May 20, 2014 by Jenifer Dorsey

How well do you know your health insurance benefits? A recent Kaiser Family Foundation survey found that 60 percent of participating women did not know insurers must cover at least one preventive care visit annually.1

It is true: All health insurance plans that qualify as minimum essential coverage under Obamacare must include certain preventive care benefits without cost sharing (i.e., copayment or coinsurance) even if you have not yet met your deductible. A yearly well-woman visit that includes a full checkup, shots and other disease prevention services, screenings to test for diseases, and education and counseling to help you make health decisions, is among these preventive benefits.2
Many of the preventive services included in health insurance plans under the Affordable Care Act took effect with policies that began on or after Sept. 23, 2010.3 The 22 covered preventive services for women, including pregnant women, took effect with plans starting on or after Aug. 1, 2012.4 They include the following5:

  1. Anemia screening on a routine basis for pregnant women
  2. Breast Cancer Genetic Test Counseling (BRCA) for women at higher risk for breast cancer
  3. Breast Cancer Mammography screenings every 1 to 2 years for women over 40
  4. Breast Cancer Chemoprevention counseling for women at higher risk
  5. Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
  6. Cervical Cancer screening for sexually active women
  7. Chlamydia Infection screening for younger women and other women at higher risk
  8. 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.”
  9. Domestic and interpersonal violence screening and counseling for all women
  10. Folic Acid supplements for women who may become pregnant
  11. Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
  12. Gonorrhea screening for all women at higher risk
  13. Hepatitis B screening for pregnant women at their first prenatal visit
  14. HIV screening and counseling for sexually active women
  15. Human Papillomavirus (HPV) DNA Test every 3 years for women with normal cytology results who are 30 or older
  16. Osteoporosis screening for women over age 60 depending on risk factors
  17. Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  18. Sexually Transmitted Infections counseling for sexually active women
  19. Syphilis screening for all pregnant women or other women at increased risk
  20. Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
  21. Urinary tract or other infection screening for pregnant women
  22. Well-woman visits to get recommended services for women under 65

These services must be performed by an in-network health care provider, so check with your health insurance plan before your visit to ensure your provider is covered in-network.
To learn more about each of these services and other ACA-covered preventive services for adults and children, visit healthcare.gov.

1 Gillespie, Lisa. “Survey: Many Women Unaware How Health Law Benefits Them.” Capsules: The Kaiser Health News Blog. May 15, 2014.
2 U.S. Department of Health and Human Services. “Get Your Well-Woman Visit Every Year.” Last revised May 16, 2014.
3 U.S. Department of Health and Human Services. “Affordable Care Act Rules on Expanding Access to Preventive Services for Women.” Last revised June 28, 2013.
4 Ibid.
5 HealthCare.gov. “What are My Preventive Care Benefits?” n.d.

Jenifer Dorsey is a freelance writer whose specialties include health and fitness, wellness, sports and recreation. She is a competitive amateur track cyclist who also enjoys mountain biking, hiking, camping and other outdoor adventure. Jenifer received a B.A. in journalism from Columbia College Chicago and is an MFA candidate at Naropa University. She lives in Colorado.