Starting August 1, 2012, the Patient Protection & Affordable Care Act, President Obama’s signature Health Care Law, requires all insurance companies to offer free coverage for an additional eight preventive health care services for women.
The new free coverage, without any co-pays, must be included in all new health insurance policies issued after August 1, 2012, and will take effect for all existing policies upon their first renewal after August 1, 2012.
In a news release issued July 31, the U.S. Department of Health & Human Services (HHS) said that “approximately 47 million women are in health plans that must cover these new preventive services at no charge.”
“Women, not insurance companies, can now make health decisions that will keep them healthy, catch potentially serious conditions at an earlier state, and protect them and their families from crushing medical bills,” HHS said.
The eight new free preventive care benefits for women are in addition to the many free preventive care benefits already made available to men and women under the Affordable Care Act, as described further below.
The New Preventive Care Benefits for Women
The eight new preventive care services that will become available to women free to charge (as summarized by HHS on HealthCare.gov), include:
- “Well-woman visits: This will include an annual well-woman preventive care visit for adult women to obtain the recommended preventive services, and additional visits if women and their health care providers determine they are necessary. These visits will help women and their health care providers determine what preventive services are appropriate, and set up a plan to help women get the care they need to be healthy.
- Gestational diabetes screening: This screening is for women 24 to 28 weeks pregnant, and those at high risk of developing gestational diabetes. It will help improve the health of mothers and babies because women who have gestational diabetes have an increased risk of developing type 2 diabetes in the future. In addition, the children of women with gestational diabetes are at significantly increased risk of being overweight and insulin-resistant throughout childhood.
- HPV DNA testing: Women who are 30 or older will have access to high-risk human papillomavirus (HPV) DNA testing every three years, regardless of Pap smear results. Early screening, detection, and treatment have been shown to help reduce the prevalence of cervical cancer.
- STI counseling: Sexually-active women will have access to annual counseling on sexually transmitted infections (STIs). These sessions have been shown to reduce risky behavior in patients, yet only 28 percent of women aged 18-44 years reported that they had discussed STIs with a doctor or nurse.
- HIV screening and counseling: Sexually-active women will have access to annual counseling on HIV. Women are at increased risk of contracting HIV/AIDS. From 1999 to 2003, the Centers for Disease Control and Prevention reported a 15% increase in AIDS cases among women, and a 1% increase among men.
- Contraception and contraceptive counseling: Women will have access to all Food and Drug Administration (FDA)-approved contraceptive methods, sterilization procedures, and patient education and counseling. These recommendations do not include abortifacient drugs. Most workers in employer-sponsored plans are currently covered for contraceptives. Contraception has additional health benefits like reduced risk of cancer and protection against osteoporosis.
- Breastfeeding support, supplies, and counseling: Pregnant and postpartum women will have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment. Breastfeeding is one of the most effective preventive measures mothers can take to protect their health and that of their children. One of the barriers for breastfeeding is the cost of purchasing or renting breast pumps and nursing related supplies.
- Interpersonal and domestic violence screening and counseling: Screening and counseling for interpersonal and domestic violence should be provided for all adolescent and adult women. An estimated 25% of women in the United States report being targets of intimate partner violence during their lifetimes. Screening is effective in the early detection and effectiveness of interventions to increase the safety of abused women.”
As to certain of these benefits, such as contraception, HHS said in its release, “certain nonprofit religious organizations, such as churches and schools, are not required to cover these services.” “The Obama administration will continue to work with all employers to give them the flexibility and resources they need to implement the health care law in a way that protects women’s health while making common-sense accommodations for values like religious liberty,” HHS stated.
The above 8 new free preventive health care benefits for women are in addition to the multiple free preventive health care services already available to women and men – both in private plans and Medicare – under the Affordable Care Act. Because of the Health Care Law, women already have the right to free preventive tests and services, such as mammograms, cholesterol screenings, and flu shots, without coinsurance or deductibles, and both men and women have many other free preventive health care services available to them (see below).
“Today’s announcement [of the new prevention benefits for women going into effect for plans issued or renewed after August 1, 2012] builds on these [existing] benefits, generally requiring insurance companies to offer, with no copay, additional vital screenings and tests to help keep women healthy throughout their lives,” HHS said in its release.
“These services are based on recommendations from the Institute of Medicine, which relied on independent physicians, nurses, scientists, and other experts as well as evidence-based research to develop its recommendations,” HHS explained.
Preventive Services Already Available under Affordable Care Act
The Health Care Law already requires all job related health plans and all insurers under individual health insurance policies newly issued after March 23, 2010 or renewed after September 23, 2010 to provide a long list or free preventive health care services.
The following list from HealthCare.gov provides just a small example of some of the existing preventive services that are already available to men, women and children because of the Affordable Care Act:
- Blood pressure, diabetes, and cholesterol tests
- Many cancer screenings, including mammograms and colonoscopies
- Counseling on such topics as quitting smoking, losing weight, eating healthfully, treating depression, and reducing alcohol use
- Regular well-baby and well-child visits, from birth to age 21
- Routine vaccinations against diseases such as measles, polio, or meningitis
- Counseling, screening, and vaccines to ensure healthy pregnancies
- Flu and pneumonia shots – Visit Vaccines.gov to learn more
In fact, according to HealthCare.gov, the free preventive health care services already covered under the Affordable Care Act for all persons with a new health insurance plan or insurance policy beginning or renewed on or after September 23, 2010 include:
- 16 Covered Preventive Services for Adults
- 22 Covered Preventive Services for Women, Including Pregnant Women
- 27 Covered Preventive Services for Children
In addition, “Women Medicare beneficiaries [can] already receive such preventive services as annual wellness visits, mammograms, and bone mass measurement for those at risk of osteoporosis and diabetes screening,” HHS pointed out in its July 31 news release. “Approximately 24.7 million women with Medicare used at least one free preventive service in 2011, including the new annual wellness visit.”
Under the Affordable Care Act, Medicare beneficiaries became entitled to many additional free preventive care benefits, starting on January 1, 2011. These include Annual Wellness Visits, Tobacco Use Cessation Counseling, and many Screenings. For a complete list with links to more information, see Medicare Preventive Services on the HealthCare.gov site.
HHS News Release on the 8 New Prevention Benefits Available for Women after August 1, 2012
In its news release about the 8 new preventive care benefits going into effect for 47 million women under plans issued or renewed after August 1. 2012, HHS concluded:
“Because of the Affordable Care Act, secure, affordable coverage is becoming a reality for millions of American women and families. Men and children are also able to take advantage of preventive services at no extra charge under the health care law. These services include flu shots and other immunizations, screenings for cancers, high blood pressure and cholesterol, and depression.
To learn more about the health care services you may be eligible for at no extra charge under the Affordable Care Act, go to http://www.healthcare.gov/prevention.”
A complete copy of the HHS News Release issued July 31, 2012 appears on the HHS Website.
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