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Free Birth Control? What's Covered By Insurance Under 'Preventive Services'

Affordable Care Act To Pay for Contraception - Here's a List of What's Covered


Updated August 02, 2011
When the Affordable Care Act was signed into law by President Obama on March 13, 2010, it already had a number of provisions for insured women to access and afford preventive services such as mammograms, cervical cancer screenings and prenatal care. But the ACA’s goal of optimizing women’s health and well-being was weakened by gaps in other areas -- an oversight that led the US Department of Health and Human Services (HHS) to seek expert advice in developing more comprehensive coverage.

On July 19, 2011, a report released by the Institute on Medicine recommended eight preventive services be made available at no cost to women. Based on those finding, on August 1, 2011, HHS announced new guidelines requiring insurance companies to provide the following free preventive services without any co-pay or deductible to women:

  1. Well-Woman Visits
    An annual well-woman preventive care visit will be covered for adult women to obtain the recommended preventive services that are age and developmentally appropriate, including preconception and prenatal care. This well-woman visit should include additional preventive services (described below) where appropriate.
  2. Contraception and Counseling
    For women of reproductive age, all Food and Drug Administration (FDA) approved contraceptive methods, sterilization procedures, and patient education and counseling will be covered.

    These include prescription barrier methods, hormonal methods, emergency contraception, implanted devices, and permanent methods of contraception for women.

    Among the contraceptive methods covered:

  3. HIV Screening and Counseling
    For all sexually active women, annual screening and counseling for human immune-deficiency virus (HIV) infection will be covered.
  4. STI Counseling
    For all sexually active women, annual counseling on sexually transmitted infections (STIs) will be covered.
  5. HPV DNA Testing
    For adult women, high-risk human papillomavirus (HPV) DNA testing will be covered. The coverage includes screening which should begin at age 30 and should occur no more frequently than every 3 years.
  6. Gestational Diabetes Screening
    For all pregnant women, gestational diabetes screening will be covered. For pregnant women not at risk of diabetes, gestational diabetes screening should be done between 24 and 28 weeks of gestation. For pregnant women identified to be at high risk of diabetes, gestational diabetes screening should occur at the first prenatal visit.
  7. Breastfeeding Support
    For women who are pregnant and/or have given birth, breastfeeding support, supplies and counseling will be covered. This includes comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment. Coverage is provided in conjunction with each birth.
  8. Domestic Violence Counseling
    For all women, screening and counseling for interpersonal and domestic violence is covered.

While all of the preventive services have -- in the words of HHS -- "strong scientific evidence of their health benefits," the requirement to provide contraception at no cost is a groundbreaking move that has angered conservative groups and faith-based organizations. On the day the new guidelines were announced, White House advisor Stephanie Cutter defended the decision to include contraception, telling ABC News, "Most private health care plans, including the private health care plan available to members of Congress, already include most of these services, including contraception."

No cost coverage of the above preventive services for women goes into effect August 1, 2012.

Group health plans sponsored by certain religious employers, and group health insurance coverage in connection with such plans, are exempt from the requirement to cover contraceptive services.

"Birth Control Guide." US Food and Drug Administration, FDA.gov. 26 July 2010.
"IOM Report Recommends Eight Additional Preventive Health Services to Promote Women's Health." Office of News and Public Information, NationalAcademies.org. 19 July 2011.
Pereira, Jennifer and Kevin Dolak. "Birth Control Free for All: New Insurance Rules Affect Millions of Women." ABC News/Health at abcnew.go.com
"Women's Preventive Services: Required Health Plan Coverage Guidelines." US Department of Health and Human Services, Health Resources and Services Administration, HRSA.gov. Retrieved 2 August 2011.

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