Women’s Health Care under the Affordable Care Act

One of the biggest fears facing women in the U.S. is that they won’t be able to afford medical care. And in fact, many have delayed or put off getting preventive and basic care simply because they couldn’t afford it, according to a recent report by the Commonwealth Fund.

This means they aren’t going to the doctor with an infection that could easily be treated or finding out if they have a threatening disease such as cancer. Until recently, insurance companies didn’t have to cover routine screening exams for women and soon they won’t be able to refuse to cover women who have pre-existing conditions.

These are among the provisions of the Affordable Care Act, upheld last month by the Supreme Court. The law has already ushered in significant changes in health care coverage for women and more are on the way. It is important for women to know what is available to them now and what is coming so that they can make good decisions to protect their own health and that of their families.

Preventive Services

The law requires that all private insurance plans in existence when it passed in March 2010 provide preventive services such as mammograms, pap smears, colon cancer and osteoporosis screening without cost sharing.

Services specifically for women

Starting next month, private insurance plans must cover an additional set of preventive services including family planning without cost sharing. Women can’t be charged higher premiums because of their gender or health.

Coverage for young women

Insurance plans that cover dependents must allow young adults to enroll in their parents’ health insurance until they are 26. An estimated 31 million young women have stayed on or joined their parents’ plan since this provision went into effect.

Annual or lifetime limits

Insurance companies can no longer place annual or life time limits on essential services. This is especially important to women who are struggling with catastrophic or chronic health issues.

Preexisting conditions

Women with existing health issues now have access to special health insurance plans if they have been uninsured for at least six months. Already, nearly 62,000 people have enrolled in such plans, at least half of them women.

Health plans that cover children can no longer limit or deny benefits for kids up to age 19 because of pre-existing conditions, a health problem, disease, or disability developed before the parent applied for health coverage. Starting in 2014, this provision will be extended to adults.

Health plans are banned from dropping people when they develop an illness or medical condition.

Medicare

As with private health insurance plans, women with Medicare part B can now receive some proven preventive services at no cost to them, including a yearly wellness exam, mammograms, bone mass measurement, and screenings for diabetes.

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