Thanks to Obamacare, millions of American women finally have access to meaningful preventative health care services.
The Affordable Care Act – the health insurance reform legislation passed by Congress and signed into law by President Obama on March 23, 2010 – helps make prevention affordable and accessible for all Americans by requiring health plans to cover preventive services and by eliminating cost sharing for those services. Preventive services that have strong scientific evidence of their health benefits must be covered and plans can no longer charge a patient a copayment, coinsurance or deductible for these services when they are delivered by a network provider.
Women’s Preventive Services Guidelines Supported by the Health Resources and Services Administration
Under the Affordable Care Act, women’s preventive health care – such as mammograms, screenings for cervical cancer, prenatal care, and other services – generally must be covered with no cost sharing. However, the law recognizes and the U.S. Department of Health and Human Services (HHS) understands the need to take into account the unique health needs of women throughout their lifespan.
The Health Resources and Services Administration (HRSA) supported health plan coverage guidelines, developed by the Institute of Medicine (IOM), will help ensure that women receive a comprehensive set of preventive services without having to pay a co-payment, co-insurance or a deductible. HHS commissioned an IOM study to review what preventive services are necessary for women’s health and well-being and therefore should be considered in the development of comprehensive guidelines for preventive services for women. HRSA is supporting the IOM’s recommendations on preventive services that address health needs specific to women and fill gaps in existing guidelines.
26 Preventive care benefits for women
All Marketplace health plans and many other plans must cover the following list of preventive services for women without charging a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.
Services for pregnant women or women who may become pregnant
- Anemia screening on a routine basis
- Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
- 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.” Learn more about contraceptive coverage.
- Folic acid supplements for women who may become pregnant
- Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
- Gonorrhea screening for all women at higher risk
- Hepatitis B screening for pregnant women at their first prenatal visit
- Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
- Syphilis screening
- Expanded tobacco intervention and counseling for pregnant tobacco users
- Urinary tract or other infection screening
Get more information about services for pregnant women from HealthFinder.gov
Other covered preventive services for women
- Breast cancer genetic test counseling (BRCA) for women at higher risk
- Breast cancer mammography screenings every 1 to 2 years for women over 40
- Breast cancer chemoprevention counseling for women at higher risk
- Cervical cancer screening for sexually active women
- Chlamydia infection screening for younger women and other women at higher risk
- Domestic and interpersonal violence screening and counseling for all women
- Gonorrhea screening for all women at higher risk
- HIV screening and counseling for sexually active women
- Human Papillomavirus (HPV) DNA test every 3 years for women with normal cytology results who are 30 or older
- Osteoporosis screening for women over age 60 depending on risk factors
- Rh incompatibility screening follow-up testing for women at higher risk
- Sexually transmitted infections counseling for sexually active women
- Syphilis screening for women at increased risk
- Tobacco use screening and interventions
- Well-woman visits to get recommended services for women under 65
More on prevention
- Learn more about preventive care from the CDC.
- See preventive services covered for all adults and children.
- Learn more about what else Marketplace health insurance plans cover.
 Women’s Preventive Services Guidelines, http://www.hrsa.gov/womensguidelines/ (accessed May 14, 2016).
 ACA Rules on Expanding Access to Preventive Services for .., http://www.hhs.gov/healthcare/facts-and-features/fact-sheets/aca-rules-on-expand… (accessed May 14, 2016).
 Preventive care benefits for women | HealthCare.gov, https://www.healthcare.gov/preventive-care-women/ (accessed May 14, 2016).
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