Women’s Health

Are there any preventive services for women specifically?

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Yes, the ACA includes a number of preventive services for women that ACA-compliant  private plans are required to cover without cost sharing. Preventive services include: counseling and screening services including prenatal and preconception care; breast and cervical cancer screening; genetic counseling and testing for women at high risk of breast cancer; chlamydia and gonorrhea screening and counseling for high risk women; at least one well woman visit a year; contraceptive counseling, services and supplies including FDA-approved , granted, or cleared contraceptives  prescribed for women, effective family planning practices, and sterilization procedures for women; breastfeeding counseling and support services including breast pump rental; and intimate partner violence screening and counseling. So long as the preventive service is performed by an in-network provider, is not billed separately from the office visit, and is the main reason for the office visit, then the visit and the preventive service will be covered by the insurer without cost sharing. 

If you are covered by a plan that was in effect on or before March 23, 2010, it may be a “grandfathered plan.” These plans are not required to cover preventive services, or they may require cost sharing. If you are not sure if your plan is grandfathered, check with your employer or your insurance plan.

If you are enrolled in an employer-sponsored plan and the employer has a religious or moral objection to contraceptives, your plan may not include contraceptive coverage.

Additionally, short-term health insurance policies do not have to provide benefits required by the ACA and may not cover preventive services. Health care sharing ministries, which are membership groups usually affiliated with a religion that help members pay for health care (not insurance), are also not subject to ACA benefit requirements.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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