The 22 Healthcare Services Provided to Women for Free

The 22 Healthcare Services Provided to Women for Free

Preventive care is important to healthy individuals and communities. Chronic diseases, which are typically the most preventable, are responsible for 7 out of 10 deaths each year and nearly one out of every two adults has one.[1] Yet, many women miss out on services and screenings that alert them to such health problems early on, when they are most treatable.A 2013 Kaiser Women’s Health Survey found that 20 percent of women 18 to 64 reported putting off or postponing preventive services in the past year due to cost.[2] Research shows that cost sharing, even when it is moderate, reduces the likelihood that women will seek preventive care such as mammograms and Pap smears. In one study, when cost-sharing was removed, the rate of women who got a mammogram increased as much as 9 percent.[3]

The Affordable Care Act attempts to improve access to preventive care by removing this cost barrier. The health care reform law requires that certain preventive services for women be included in health insurance coverage and without cost-sharing requirements. These preventive services are not subject to coinsurance, copayments or your deductible when you visit a network provider. They are, essentially, free.

Four in 10 American women are unaware of this coverage[4]—coverage that 48.5 million women are estimated to benefit from and that has been linked to A) a quadruple increase in oral contraception prescriptions dispensed with no copay from 2012 to 2013 and B) a $483.3 million reduction in out-of-pocket costs in 2013 as a result of that increase.[5] Birth control is only part of it, though.

All qualified health insurance plans sold on and away from the exchanges today and many grandfathered plans include these 22 preventive services for women[6],[7],[8]:

  1. Anemia screening — On a routine basis for pregnant women
  2. Breast cancer genetic test counseling (BRCA) — Higher-risk women
  3. Breast cancer mammography screenings — Women over 40, every one to two years
  4. Breast cancer chemoprevention counseling — Higher-risk women
  5. Breastfeeding support, supplies and counseling* — Comprehensive lactation support and counseling by a trained provider during pregnancy and/or in the postpartum period; costs for renting breastfeeding equipment; in conjunction with each birth
  6. Cervical cancer screening — Sexually active women
  7. Chlamydia infection screening — Younger women and women at higher risk
  8. Contraception and contraceptive counseling* — All FDA-approved contraceptive methods, sterilization procedures and patient education and counseling for all women with reproductive capacity, as prescribed—may not apply to women who participate in group health plans sponsored by religious employers
  9. Domestic and interpersonal violence screening and counseling* — All women
  10. Folic acid supplements — Women who may become pregnant
  11. Gestational diabetes screening* — Between 24 and 28 weeks of pregnancy and at the first prenatal visit for pregnant women identified as high-risk for diabetes
  12. Gonorrhea screening — Higher-risk women
  13. Hepatitis B screening — Pregnant women, at first prenatal visit
  14. HIV screening and counseling* — Annual for sexually active women
  15. Human papillomavirus (HPV) DNA testing* — Starting at age 30 and no more frequently than every three years for women with normal cytology results
  16. Osteoporosis screening — Women over 60, dependent on risk factors
  17. Rh incompatibility screening — All pregnant women, followup testing for higher-risk women
  18. Sexually transmitted infections counseling* — Annual for sexually active women
  19. Syphilis screening — All pregnant women and other women at increased risk
  20. Tobacco use screening and interventions — All women, expanded for pregnant women who use tobacco
  21. Urinary tract or other infection screening — Pregnant women
  22. Well-women visits* — Annual visits for recommended preventive services that are age and developmentally appropriate, including preconception care and many services necessary for prenatal care. The visit should also include other preventive services, when appropriate.

*Health insurance plans effective Sept. 23, 2010, and later should include the services listed without an asterisk. Those effective Aug. 1, 2012, and later should include all 22 services.

The Affordable Care Act also covers additional preventive services for all adults and children. Visit HHS.gov for a full list.

Assess your health plan

If you currently have a grandfathered health insurance plan—coverage in effect prior to Jan. 1, 2014—does it include these preventive services? If not, what are you waiting for? Investigate your plan options and during 2015 open enrollment and make the switch.

If you shop your state’s exchange, you may be eligible for a premium tax credit to lower your monthly premium rate. Use the HealthCare.com subsidy calculator to see if you qualify. If you do, visit your state’s state-based or federally facilitated exchange to enroll.

Get preventive

If you already have coverage that includes these preventive services, have you used them? Schedule a your well-woman visit as soon as possible to get the most out of your coverage.

When you go, know your benefits and talk to your doctor about which screenings and services are right for you. A Kaiser study found that while the majority of women, 82 percent, had recent checkups, significant percentages did not engage in preventive counseling on key health topics such as smoking (44 percent), alcohol and drug use (31 percent), mental health (41 percent), and diet and exercise (70 percent) during these visits.[9]

This appointment may reveal new health concerns, which could impact your plan choice for 2015. If you need help shopping for 2015 health insurance coverage, contact a certified helper through your state’s exchange or call 877-275-0485 to talk to a licensed health insurance agent from one of HealthCare.com’s insurance partners.

 

 

 

 

 

 

[1] U.S. Centers for Disease Control and Prevention. “National Prevention Strategy: America’s Plan for Better Health and Wellness.” Last updated Jan. 17, 2014. http://www.cdc.gov/features/preventionstrategy/.

[2] The Henry J. Kaiser Family Foundation. “Preventive Services Covered by Private Health Plans Under the Affordable Care Act.” Oct. 28, 2014. http://kff.org/health-reform/fact-sheet/preventive-services-covered-by-private-health-plans/.

[3] U.S. Department of Health and Human Services. “Affordable Care Act Rules on Expanding Access to Preventive Services for Women.” http://www.hhs.gov/healthcare/facts/factsheets/2011/08/womensprevention08012011a.html.

[4] The Henry J. Kaiser Family Foundation and the Journal of the American Medical Association. “Visualizing Health Policy: Preventive Services for Women and the ACA.” May 14, 2014. http://jama.jamanetwork.com/article.aspx?articleid=1869217.

[5] Burke, Amy and Adelle Simons. “Increased Coverage of Preventive Services with Zero Cost-Sharing Under the Affordable Care Act.” ASPE Issue Brief. June 27, 2014. http://aspe.hhs.gov/health/reports/2014/PreventiveServices/ib_PreventiveServices.pdf.

[6] U.S. Department of Health and Human Services. “Preventive Services Covered Under the Affordable Care Act.”http://www.hhs.gov/healthcare/facts/factsheets/2010/07/preventive-services-list.html.

[7] U.S. Department of Health and Human Services. Health Resources and Services Administration. “Women’s Preventive Services Guidelines.” http://www.hrsa.gov/womensguidelines/.

[8] U.S. Department of Health and Human Services. “Affordable Care Act Rules on Expanding Access to Preventive Services for Women.” http://www.hhs.gov/healthcare/facts/factsheets/2011/08/womensprevention08012011a.html.

[9] The Henry J. Kaiser Family Foundation and the Journal of the American Medical Association. “Visualizing Health Policy: Preventive Services for Women and the ACA.” May 14, 2014. http://jama.jamanetwork.com/article.aspx?articleid=1869217.

About Jenifer Dorsey

Jenifer Dorsey is a regular contributor to HealthCare.com. She has covered health insurance and health and fitness for more than five years. In her free time she is a competitive track cyclist and loves to travel, especially to places with velodromes.

Comments