New Mandates on Insurance, Many Free, Go Into Effect
August 3, 2011
On Monday, the U.S. Department of Health and Human Services unveiled a list of preventive health services for women that insurers will be required to cover without a co-pay. The policy, which follows recommendations recently issued by the independent Institute of Medicine, greatly boosts free reproductive health coverage under the Affordable Care Act (ACA).
"These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need," said Kathleen Sebelius, the department's secretary.
Services to be covered at no additional cost include:
- annual well-woman visits;
- screening for gestational diabetes;
- human papillomavirus DNA testing for women age 30 and older;
- STI counseling;
- HIV screening and counseling;
- breastfeeding support and supplies;
- FDA-approved contraception and contraceptive counseling; and
- domestic violence screening and counseling.
The requirements are effective on Aug. 1, 2012, or January 2013 for plans that operate on the calendar year. Insurance plans that were in place when ACA was signed into law on March 23, 2010, may avoid the requirements until plan modifications automatically trigger their application. Certain religious organizations that offer health plans would be exempt from the contraception requirements.
ACA generally bans co-payments, deductibles, and other charges for preventive services, and it already included other STD screenings. However, insurers can apply "reasonable medical management techniques" to control costs and promote care delivery. For instance, insurers could charge co-pays for brand-name drugs if a generic equivalent were available, officials said.
ACA still faces repeal efforts by some Republican members of Congress.
For more information about the guidelines, visit: www.hrsa.gov/womensguidelines/.
New York Times
08.02.2011; Robert Pear
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