Preventive Care for Women Now Available Without Cost-Sharing

The Affordable Care Act requires certain women’s preventive health services to be made available without cost-sharing for plan years beginning on or after August 1. There has been a lot of media coverage on this provision, but the National Health Law Program has a great Q&A to answer all your questions on what services are covered, and whether your insurance plan is one that’s required to provide those preventive services. Here are some highlights:

  • The covered services are evidence-based and proven to improve a woman’s overall health.
  • Individual and group (i.e. employee) health insurance plans, including self-insured employer plans, must meet these coverage requirements unless they are “grandfathered.” The requirements apply to plans sold inside and outside of the health insurance exchanges. “Grandfathered” plans are a very narrow category.
  • Although the women’s preventive services requirements go into effect on August 1, 2012, plans do not have to begin providing enrollees with the required coverage until the next policy year (for individual insurance plans) or plan year (for group insurance plans) beginning on or after August 1, 2012. You should check with your insurance provider to learn the dates of your particular plan or policy years.
  • You may have to pay some of the cost out-of-pocket for office visits depending on how your doctor bills the insurance company. Check with your doctor and/or insurance company if you have any questions on what you might pay out-of-pocket.

Preventive services are an important part of keeping people healthy.  Limiting or eliminating out-of-pockets costs to you will result in greater access to these services.

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