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Insurance changes, high deductibles, and faulty marketplace applicability are just a few of the burdensome changes invoked as a result of the ACA. Despite the many changes we’re sure to see in our insurance plans, keep in mind that many of the currently available preventive health screenings not only will continue to be available, but importantly, will be covered at no cost to you (no deductible and no co-pay,) by the ACA mandates. Annual Pap smear screenings, mammograms, contraception, and vaccinations will be covered by most insurance plans as a “No-fee Preventative benefit”, even if you participate in a high deductible plan.
Whether you find yourself needing to purchase insurance on the marketplace, or not, it’s possible that you may find changes in your current insurance coverage, such as the institution of higher deductibles. Studies show that participants of high deductible plans are less likely to utilize health services, even those services that are covered at ‘no cost’.
Other recent studies show that fewer than 50 percent of women 18 to 45 know that the Affordable Care Act requires health insurance plans to provide free contraceptives to women for birth control methods (including birth control pills, IUDs, and sterilizations.) Further, women no longer need a referral to see a gynecologist. Maternity care is provided, as well as counseling and resources for breastfeeding. STD screening, counseling and resources for depression and domestic violence are also provided as preventive health services, and at no cost to you.
According to the U.S. Department of Health’s Health Resources and Services Administration, “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.” Below is a list of covered preventive health services available for women.
Type of Preventive Service |
Explanation |
Frequency |
Well-woman visits.
Gynecologist visits.
Cancer Screening.
Mammograms
Pap Smear |
Well-woman preventive care visit annually for adult women
No referral needed
Breast cancer screening beginning at age 40
Cervical cancer screening |
Annually
Annually
Annually |
Screening for gestational diabetes. |
Screening for gestational diabetes in pregnant women between 24-28 weeks |
Each pregnancy |
Human papillomavirus testing. |
HPV DNA testing in women with normal cytology results. |
Annually |
Counseling for sexually transmitted infections. |
Counseling on sexually transmitted infections for all sexually active women |
Annually |
Counseling and screening for HIV |
For all sexually active women. |
Annually |
Contraceptive methods and counseling. |
All Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity. |
As needed |
Breastfeeding support, supplies, and counseling. |
Lactation support and counseling during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment. |
Each pregnancy |
Screening and counseling for interpersonal and domestic violence. |
Screening and counseling for interpersonal and domestic violence |
As needed |
Don’t allow the hassles and the unknowns of our current state of insurance change cause you to default on following through with your own preventative health services. Be aware of what your current plan does cover for you, and take advantage of the preventive health services that are available to you at ‘no cost’. Contact your doctor’s office to assist you in navigating these changes, and to schedule your yearly Pap smear, mammogram, or preventive health exam.
Suzanne Hall, MD (@drsuzyyhall)
Women’s Health Medical Blogger at GynoGroupie.com
Eastside Gynecology Obstetrics, PC
Offices located in Macomb, Rochester, Roseville, and Grosse Pointe
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